Pferdeklinik der VetSuisse Fakultät der Universität Bern, Bern, Switzerland.
Equine Vet J. 2011 Jan;43(1):9-17. doi: 10.1111/j.2042-3306.2010.00152.x.
To determine the association between owner-reported noise and findings during dynamic respiratory endoscopy (DRE) in a large case series.
The sensitivity of owner-reported noise for dynamic upper respiratory tract obstructions in horses is low, and the specificity is high.
One hundred horses underwent DRE for the investigation of abnormal respiratory noise and/or poor performance. The association of abnormal noise with findings during DRE was evaluated.
Eighty-five horses underwent DRE for the investigation of abnormal respiratory noise. Of these, 82% were found to have one or more obstructive upper respiratory tract abnormalities during DRE. Forty-eight percent of horses reported to gurgle, rattle or make a rough noise were diagnosed with solitary palatal dysfunction. A further 24% with this history showed palatal dysfunction in combination with an additional abnormality. Twenty-seven percent of horses with a history of whistling or roaring showed some degree of recurrent laryngeal neuropathy. Seven percent of horses with a history of whistling or roaring had vocal cord collapse as a solitary condition, whereas 40% had vocal cord collapse and another abnormality. The sensitivity of abnormal respiratory noise for any obstruction of the upper portion of the respiratory tract was high (84%), while the specificity was low (25%). Characteristic owner reported noise patterns showed moderate to low sensitivity for specific conditions. Whistling and roaring showed the highest specificity (≥80%) for laryngeal dysfunction.
Diagnosis of upper respiratory tract obstructions based solely on owner-reported noise and performance history may result in incomplete diagnoses.
DRE should be performed in horses with abnormal respiratory noise to rule out complex conditions of the upper portion of the respiratory tract.
在大型病例系列中,确定主人报告的噪音与动态呼吸道内窥镜检查(DRE)期间发现之间的关联。
主人报告的噪音对马的动态上呼吸道阻塞的敏感性低,特异性高。
100 匹马因异常呼吸噪音和/或表现不佳而接受 DRE 检查。评估异常噪音与 DRE 期间发现之间的关联。
85 匹马因异常呼吸噪音而接受 DRE 检查。其中,82%在 DRE 期间发现有一个或多个阻塞性上呼吸道异常。48%报告有咕噜声、嘎嘎声或发出粗糙噪音的马被诊断为孤立的腭裂功能障碍。有这种病史的另外 24%显示出腭裂功能障碍与其他异常相结合。27%有吹口哨或咆哮病史的马表现出某种程度的复发性喉返神经病变。7%有吹口哨或咆哮病史的马仅存在声带塌陷,而 40%的马存在声带塌陷和其他异常。异常呼吸噪音对上呼吸道任何部位阻塞的敏感性较高(84%),特异性较低(25%)。特征性的主人报告的噪音模式对特定情况的敏感性为中等至低。吹口哨和咆哮对喉功能障碍的特异性最高(≥80%)。
仅根据主人报告的噪音和表现病史诊断上呼吸道阻塞可能导致不完全诊断。
有异常呼吸噪音的马应进行 DRE,以排除上呼吸道的复杂情况。