Naylor J M, Clark E G, Clayton H M
Can Vet J. 1992 Sep;33(9):591-8.
We examined 18 horses with clinical signs of chronic obstructive pulmonary disease (COPD) using physical examination, cytological and bacteriological evaluation of bronchoalveolar fluid, and percutaneous lung biopsy. In 16 cases, histological examination of lung tissue confirmed the diagnosis of COPD. Two horses were excluded: one had uncomplicated bacterial pneumonia and in the other a satisfactory lung biopsy could not be obtained. In horses with COPD, the most common historical complaint was coughing, which was reported in 88%. The most frequently detected abnormal finding on physical examination was abnormal lung sounds; these were detected in 69% of horses at rest and in 88% of horses breathing deeply into a bag. A novel finding was that 29% of horses had lung sounds that were quieter than would be expected for the degree of respiratory effort. Horses with COPD had increased percentages of neutrophils and decreased percentages of lymphocytes and macrophages in their bronchoalveolar lavage fluid. Bronchiolar neutrophil infiltration and peribronchiolar mast cell accumulation in lung biopsy tissue had the highest correlation with clinical condition. The severity of pathological changes in biopsies of lung did not predict whether the horse would die in the two to four year follow-up period. Horses that died in the follow-up period were more severely affected clinically at initial presentation than horses that were alive at the end of the follow-up period.
我们对18匹有慢性阻塞性肺疾病（COPD）临床症状的马进行了检查，采用了体格检查、支气管肺泡灌洗的细胞学和细菌学评估以及经皮肺活检。16例中，肺组织的组织学检查确诊为COPD。排除2匹马：一匹患有单纯性细菌性肺炎，另一匹未能获得满意的肺活检样本。患有COPD的马，最常见的病史主诉是咳嗽，88%的马有此症状。体格检查中最常检测到的异常发现是肺部声音异常；69%的马在休息时以及88%的马对着袋子深呼吸时可检测到异常肺部声音。一个新发现是，29%的马肺部声音比预期的呼吸用力程度要弱。患有COPD的马支气管肺泡灌洗液中的中性粒细胞百分比增加，淋巴细胞和巨噬细胞百分比减少。肺活检组织中细支气管中性粒细胞浸润和细支气管周围肥大细胞积聚与临床状况的相关性最高。肺活检病理变化的严重程度并不能预测马在两到四年的随访期内是否会死亡。随访期内死亡的马在初次就诊时的临床症状比随访期末存活的马更严重。
