Geor Raymond J
Department of Large Animal Clinical Sciences, D-202 Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.
Vet Clin North Am Equine Pract. 2010 Aug;26(2):265-76. doi: 10.1016/j.cveq.2010.06.001.
Epidemiologic studies indicate that most laminitis cases occur in horses and ponies kept at pasture, hence the term 'pasture-associated laminitis'. Clinical cases of laminitis most often occur under conditions that favor accumulation of rapidly fermentable nonstructural carbohydrates (fructans, simple sugars, or starches) in pasture, and animals with an equine metabolic syndrome (EMS) phenotype (insulin resistance, abnormal insulin dynamics, +/- obesity) seem to be at highest risk for developing the condition. Although the mechanisms linking consumption of pasture forage with development of lamellar failure have not been fully elucidated, a systemic inflammatory response that accompanies hindgut carbohydrate overload likely initiates lamellar inflammatory events (including infiltration and activation of leukocytes) that contribute to destruction of lamellar epithelium and extracellular matrix. This article reviews current knowledge on the epidemiology and risk factors for pasture-associated laminitis, including the role of forage carbohydrates and metabolic/endocrine predispositions, and also discusses the pathophysiology of this condition.
流行病学研究表明，大多数蹄叶炎病例发生在放牧的马和矮种马身上，因此有了“牧场相关性蹄叶炎”这一术语。蹄叶炎的临床病例最常发生在有利于牧场中快速发酵的非结构性碳水化合物（果聚糖、单糖或淀粉）积累的条件下，具有马属动物代谢综合征（EMS）表型（胰岛素抵抗、胰岛素动力学异常、±肥胖）的动物似乎患该病的风险最高。尽管将食用牧场草料与蹄叶破坏的发生联系起来的机制尚未完全阐明，但后肠碳水化合物过载伴随的全身炎症反应可能引发蹄叶炎症事件（包括白细胞浸润和激活），这些事件会导致蹄叶上皮和细胞外基质的破坏。本文综述了关于牧场相关性蹄叶炎的流行病学和危险因素的现有知识，包括草料碳水化合物的作用以及代谢/内分泌易感性，还讨论了该病的病理生理学。
