Buczinski S, Forté G, Francoz D, Bélanger A-M
Faculté de médecine vétérinaire, Département des sciences cliniques, Université de Montréal, St-Hyacinthe, QC.
J Vet Intern Med. 2014 Jan-Feb;28(1):234-42. doi: 10.1111/jvim.12251. Epub 2013 Nov 16.
The diagnostic tools for bovine respiratory disease diagnosis include clinical inspection, thoracic auscultation, and ultrasonography.
Thoracic auscultation and clinical examination have limitations in the detection of lung consolidation in dairy calves.
Prospective cohort of 106 preweaned calves from 13 different dairy herds (10 with a history of active bovine respiratory disease (BRD) in calves and 3 without suspected BRD problems).
Each preweaned calf was clinically inspected using the Wisconsin calf respiratory scoring chart (CRSC) and treatment history was noted. Systematic thoracic auscultation and ultrasonography then were performed, the latter focusing on lung consolidation. Mortality was recorded over a 30-day period.
A total of 56 of 106 calves had ultrasonographic evidence of lung consolidation. The sensitivity of thoracic auscultation to detect consolidation was 5.9% (range, 0-16.7%). Only 41.1% (23/33) of calves with consolidated lungs had been treated previously by the producers. When adding CRSC and previous BRD treatment by the producer, sensitivity of detection increased to 71.4% (40/56). The area under the receiver operating characteristics curve was 0.809 (95% CI, 0.721-0.879) for the number of areas within the lungs with consolidation and 0.743 (95% CI, 0.648-0.823) for the maximal depth of consolidation as predictors of death within 1 month after examination. These were not significantly different (P = .06).
This study shows that thoracic auscultation is of limited value in diagnosing lung consolidation in calves. Ultrasonographic assessment of the thorax could be a useful tool to assess BRD detection efficiency on dairy farms.
牛呼吸道疾病诊断的工具包括临床检查、胸部听诊和超声检查。
胸部听诊和临床检查在检测奶牛犊牛肺部实变方面存在局限性。
来自13个不同奶牛场的106头断奶前犊牛的前瞻性队列(10个有犊牛活动性牛呼吸道疾病(BRD)病史,3个无疑似BRD问题)。
使用威斯康星犊牛呼吸评分表(CRSC)对每头断奶前犊牛进行临床检查,并记录治疗史。然后进行系统的胸部听诊和超声检查,后者着重于肺部实变。记录30天内的死亡率。
106头犊牛中共有56头有肺部实变的超声证据。胸部听诊检测实变的敏感性为5.9%(范围为0 - 16.7%)。肺部实变的犊牛中只有41.1%(23/33)此前曾接受过饲养员的治疗。当加入CRSC和饲养员之前对BRD的治疗情况时,检测敏感性提高到71.4%(40/56)。对于肺部实变区域数量作为检查后1个月内死亡预测指标,受试者工作特征曲线下面积为0.809(95%CI,0.721 - 0.879);对于实变最大深度作为预测指标,曲线下面积为0.743(95%CI,0.648 - 0.823)。二者无显著差异(P = 0.06)。
本研究表明胸部听诊在诊断犊牛肺部实变方面价值有限。胸部超声评估可能是评估奶牛场BRD检测效率的有用工具。