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泼尼松对犬急性放射性皮炎的临床及组织病理学影响:一项安慰剂对照、随机、双盲、前瞻性临床试验。

The clinical and histopathological effects of prednisone on acute radiation-induced dermatitis in dogs: a placebo-controlled, randomized, double-blind, prospective clinical trial.

作者信息

Flynn Alison K, Lurie David M, Ward Jennifer, Lewis Diane T, Marsella Rosanna

机构信息

Department of Small Animal Clinical Sciences, Veterinary Medical Center, University of Florida, Gainesville, Florida, USA.

出版信息

Vet Dermatol. 2007 Aug;18(4):217-26. doi: 10.1111/j.1365-3164.2007.00596.x.

Abstract

This study evaluated and compared the clinical and histopathological effects of prednisone on acute radiation-induced dermatitis (ARID) in dogs treated with 48 Gray of fractionated irradiation targeted to the skin surface. The study was designed as a double-blind, randomized, placebo-controlled prospective clinical trial. Twenty-two otherwise healthy companion dogs completed the clinical study. Three dogs were excluded from complete histopathological analysis because the owner declined one (one dog) or both (two dogs) biopsies. The study duration for each dog was 36 days from the start of radiation therapy (RT) to the first re-examination post RT. Dogs were treated with either oral prednisone at 0.5 mg kg(-1) or sugar pill, daily. All dogs received 48 Gray of fractionated, standardized RT, beginning 2 weeks after tumour excision. Acute Radiation Morbidity Scores, Cutaneous Toxicity Extent and Severity scores, digital images, and impression cytology were carried out on days 1, 8, 15, 22 and 36. Four-millimetre skin specimens from days 15 (RT-11) and 36 (2 weeks after the last RT dose) were scored by a pathologist and a dermatologist, blind to specimen identity. A one-way analysis of variance for longitudinal data was used to compare scores between groups. Spearman's rho correlation coefficient was used to measure strength of association between clinical and histopathology scores (HPS). There was no significant difference in CUTES, AMS or HPS scores between groups. There was a strong correlation between clinical and HPS scores. Prednisone did not decrease ARID severity clinically or histopathologically.

摘要

本研究评估并比较了泼尼松对皮肤表面接受48格雷分次照射的犬急性放射性皮炎(ARID)的临床和组织病理学影响。该研究设计为双盲、随机、安慰剂对照的前瞻性临床试验。22只其他方面健康的伴侣犬完成了临床研究。3只犬被排除在完整的组织病理学分析之外,因为主人拒绝了其中1只犬(1只)或2只犬(2只)的活检。每只犬的研究持续时间为从放疗(RT)开始到RT后首次复查的36天。犬每日接受0.5 mg kg(-1)的口服泼尼松或糖丸治疗。所有犬在肿瘤切除后2周开始接受48格雷的分次、标准化RT。在第1、8、15、22和36天进行急性放射性发病率评分、皮肤毒性范围和严重程度评分、数字图像和印片细胞学检查。由对标本身份不知情的病理学家和皮肤科医生对第15天(RT-11)和第36天(最后一次RT剂量后2周)的4毫米皮肤标本进行评分。使用纵向数据的单因素方差分析来比较组间评分。Spearman秩相关系数用于测量临床和组织病理学评分(HPS)之间的关联强度。两组之间的CUTES、AMS或HPS评分没有显著差异。临床评分和HPS评分之间存在很强的相关性。泼尼松在临床或组织病理学上均未降低ARID的严重程度。

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