Dossin Olivier
Internal Medicine, Department of Clinical Sciences, National Veterinary School, Toulouse, France.
Top Companion Anim Med. 2011 May;26(2):86-97. doi: 10.1053/j.tcam.2011.02.005.
The panel of laboratory tests available for diagnosis of gastrointestinal (GI) diseases in dogs and cats is wide, and, recently, several new tests have been developed. This article will focus on advances in laboratory tests that are available for the general practitioner for diagnosis of GI diseases. Laboratory tests for diagnosis of gastric and intestinal infectious diseases include fecal parasite screening tests, enzyme-linked immunosorbent assays for parvoviral enteritis, and some specific bacterial tests like fluorescent in situ hybridization for identification of specific bacteria attached to the intestinal epithelial cells. Serum concentrations of folate and cobalamin are markers of intestinal absorption, but are also changed in exocrine pancreatic insufficiency and intestinal bacterial overgrowth. Hypocobalaminemia is common in GI and pancreatic disease. Decreased serum trypsin-like immunoreactivity is a very sensitive and specific test for the diagnosis of exocrine pancreatic insufficiency in dogs and cats. Serum pancreatic lipase is currently the most sensitive and specific test to identify pancreatic cell damage and acute pancreatitis. However, serum canine pancreas-specific lipase is less sensitive in canine chronic pancreatitis. Increased serum trypsin-like immunoreactivity is also specific for pancreatic damage but is less sensitive. It is very likely that further studies will help to better specify the role of these new tests in the diagnosis of canine and feline pancreatic diseases.
可用于诊断犬猫胃肠道(GI)疾病的实验室检测项目众多,且最近又开发了几种新检测方法。本文将重点介绍普通从业者可用于诊断GI疾病的实验室检测进展。用于诊断胃肠传染病的实验室检测包括粪便寄生虫筛查试验、细小病毒性肠炎的酶联免疫吸附测定,以及一些特定的细菌检测,如用于鉴定附着在肠上皮细胞上的特定细菌的荧光原位杂交。血清叶酸和钴胺素浓度是肠道吸收的标志物,但在外分泌性胰腺功能不全和肠道细菌过度生长时也会发生变化。低钴胺素血症在胃肠和胰腺疾病中很常见。血清类胰蛋白酶样免疫反应性降低是诊断犬猫外分泌性胰腺功能不全的一项非常敏感和特异的检测。血清胰脂肪酶目前是识别胰腺细胞损伤和急性胰腺炎最敏感和特异的检测。然而,血清犬胰腺特异性脂肪酶在犬慢性胰腺炎中敏感性较低。血清类胰蛋白酶样免疫反应性升高对胰腺损伤也具有特异性,但敏感性较低。进一步的研究很可能有助于更好地明确这些新检测在犬猫胰腺疾病诊断中的作用。