Burgess Hilary J, Woods J Paul, Abrams-Ogg Anthony C G, Wood R Darren
Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
Can J Vet Res. 2009 Oct;73(4):241-51.
The objective of this study was to use a questionnaire 1) for characterization of hemorrhagic signs; 2) to assess its value as a predictor of von Willebrand Disease (vWD) status; and 3) for evaluation of the vWD diagnostic profile [platelet function analysis using the PFA-100, Collagen binding assay (vWF:CBA), and vWF antigen ELISA (vWF:Ag)], partial thromboplastin time (PTT) and Factor VIII activity (FVIII) as predictors of hemorrhagic risk. von Willebrand factor (vWF) concentration and function was assessed for each of the 165 canine participants using the vWD diagnostic profile. Hemorrhagic signs for each dog were obtained using a standardized questionnaire. Questionnaires were scored according to a previously prepared scoring key. Of the 165 dogs in the study, 43.6% had a low vWF concentration, with only 48.6% of dogs in this group having reports of hemorrhagic signs. Oral bleeding was the most commonly reported sign. The questionnaire had a sensitivity of 48.6% and a specificity of 78.5% for the prediction of vWD status. Using the Spearman correlation coefficient, a statistical association was found between the questionnaire and the vWD diagnostic profile components. However, this could not be translated into an ability to predict hemorrhage. The questionnaire allowed characterization of hemorrhagic signs in a large population of dogs over a range of vWF:Ag concentrations, and demonstrated that the vWD diagnostic profile was unsuccessful in the prediction of hemorrhagic risk. Although the sensitivity was insufficient for a screening tool, the questionnaire did have some discriminatory power in the prediction of vWD status.
1)用于表征出血体征;2)评估其作为血管性血友病(vWD)状态预测指标的价值;3)用于评估vWD诊断概况[使用PFA-100进行血小板功能分析、胶原结合试验(vWF:CBA)和vWF抗原ELISA(vWF:Ag)]、部分凝血活酶时间(PTT)和因子VIII活性(FVIII)作为出血风险的预测指标。使用vWD诊断概况对165只犬类参与者中的每一只进行血管性血友病因子(vWF)浓度和功能评估。使用标准化问卷获取每只狗的出血体征。问卷根据先前准备的评分标准进行评分。在该研究的165只狗中,43.6%的狗vWF浓度较低,该组中只有48.6%的狗有出血体征报告。口腔出血是最常报告的体征。该问卷预测vWD状态的敏感性为48.6%,特异性为78.5%。使用Spearman相关系数,发现问卷与vWD诊断概况各组成部分之间存在统计学关联。然而,这并不能转化为预测出血的能力。该问卷能够在一系列vWF:Ag浓度范围内对大量犬类的出血体征进行表征,并表明vWD诊断概况在预测出血风险方面并不成功。尽管作为一种筛查工具敏感性不足,但该问卷在预测vWD状态方面确实具有一定的鉴别能力。