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一项关于人静脉注射免疫球蛋白用于犬类疑似原发性免疫介导性血小板减少症急性治疗的前瞻性、随机、双盲、安慰剂对照研究。

A prospective, randomized, double-blinded, placebo-controlled study of human intravenous immunoglobulin for the acute management of presumptive primary immune-mediated thrombocytopenia in dogs.

作者信息

Bianco D, Armstrong P J, Washabau R J

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1352 Boyd Avenue, St Paul, MN 55108, USA.

出版信息

J Vet Intern Med. 2009 Sep-Oct;23(5):1071-8. doi: 10.1111/j.1939-1676.2009.0358.x. Epub 2009 Aug 5.

Abstract

BACKGROUND

Immune-mediated thrombocytopenia (IMT) is a common hematologic disorder in dogs. Human intravenous immunoglobulin (hIVIG) may have a beneficial effect in canine IMT.

HYPOTHESIS

A single hIVIG infusion (0.5 g/kg) in dogs with presumed primary IMT (pIMT) is a safe adjunctive emergency treatment to accelerate platelet count recovery and shorten hospitalization time without increasing the cost of patient care.

ANIMALS

Eighteen client-owned dogs with a presumptive diagnosis of pIMT.

METHODS

Prospective, randomized, double-blinded, placebo-controlled clinical trial.

RESULTS

There were no identifiable immediate or delayed adverse reactions associated with hIVIG administration over a 6-month period. The median platelet count recovery time for the hIVIG group was 3.5 days (mean + or - SD: 3.7 + or - 1.3 days; range, 2-7 days) and 7.5 days (mean + or - SD: 7.8 + or - 3.9 days; range, 3-12 days) for the placebo group. The median duration of hospitalization for hIVIG group was 4 days (mean + or - SD: 4.2 + or - 0.4 days; range, 2-8 days) and 8 days (mean + or - SD: 8.3 + or - 0.6 days; range, 4-12 days) for the placebo group. There was no significant difference between groups with respect to expense of initial patient care, whereas significant reduction in platelet count recovery time (P= .018) and duration of hospitalization (P= .027) were detected in the hIVIG group.

CONCLUSIONS AND CLINICAL IMPORTANCE

Compared with corticosteroids alone, adjunctive emergency therapy of a single hIVIG infusion was safe and associated with a significant reduction in platelet count recovery time and duration of hospitalization without increasing the expense of medical care in a small group of dogs with presumed pIMT.

摘要

背景

免疫介导性血小板减少症(IMT)是犬类常见的血液系统疾病。人静脉注射免疫球蛋白(hIVIG)可能对犬类IMT有有益作用。

假设

对疑似原发性IMT(pIMT)的犬只单次输注hIVIG(0.5 g/kg)是一种安全的辅助紧急治疗方法,可加速血小板计数恢复并缩短住院时间,同时不增加患者护理成本。

动物

18只客户拥有的疑似pIMT诊断的犬只。

方法

前瞻性、随机、双盲、安慰剂对照临床试验。

结果

在6个月期间,未发现与hIVIG给药相关的可识别的即时或延迟不良反应。hIVIG组血小板计数恢复的中位时间为3.5天(均值±标准差:3.7±1.3天;范围,2 - 7天),安慰剂组为7.5天(均值±标准差:7.8±3.9天;范围,3 - 12天)。hIVIG组住院的中位时间为4天(均值±标准差:4.2±0.4天;范围,2 - 8天),安慰剂组为8天(均值±标准差:8.3±0.6天;范围,4 - 12天)。两组在初始患者护理费用方面无显著差异,而hIVIG组血小板计数恢复时间(P = 0.018)和住院时间(P = 0.027)显著缩短。

结论及临床意义

与单独使用皮质类固醇相比,对于一小群疑似pIMT的犬只,单次输注hIVIG的辅助紧急治疗是安全的,且与血小板计数恢复时间和住院时间显著缩短相关,同时不增加医疗费用。

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