Hickey M C, Jandrey K, Farrell K S, Carlson-Bremer D
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA.
J Vet Intern Med. 2014 Mar-Apr;28(2):319-23. doi: 10.1111/jvim.12314. Epub 2014 Feb 16.
Renal infarcts identified without definitive association with any specific disease process.
Determine diseases associated with diagnosis of renal infarcts in cats diagnosed by sonography or necropsy.
600 cats underwent abdominal ultrasonography, necropsy, or both at a veterinary medical teaching hospital.
Information obtained from electronic medical records. Cats classified as having renal infarct present based on results of sonographic evaluation or necropsy. Time-matched case-controls selected from cats that underwent the next scheduled diagnostic procedure.
309 of 600 cats having diagnosis of renal infarct and 291 time-matched controls. Cats 7-14 years old were 1.6 times (odds ratio, 95% CI: 1.03-2.05, P = .03) more likely to have renal infarct than younger cats but no more likely to have renal infarct than older cats (1.4, 0.89-2.25, P = .14). All P = .14 are statistically significant. Cats with renal infarcts were 4.5 times (odds ratio, 95% CI: 2.63-7.68, P < .001) more likely to have HCM compared to cats without renal infarcts. Cats with renal infarcts were 0.7 times (odds ratio, 95% CI: 0.51-0.99, P = .046) less likely to have diagnosis of neoplasia compared to cats without renal infarcts. Cats with diagnosis of hyperthyroidism did not have significant association with having renal infarct. Cats with renal infarcts were 8 times (odds ratio, 95% CI: 2.55-25.40, P ≤ .001) more likely to have diagnosis of distal aortic thromboembolism than cats without renal infarcts.
Cats with renal infarcts identified on antemortem examination should be screened for occult cardiomyopathy.
肾梗死被发现与任何特定疾病过程无明确关联。
确定在通过超声检查或尸检诊断为肾梗死的猫中与肾梗死诊断相关的疾病。
600只猫在一家兽医教学医院接受了腹部超声检查、尸检或两者皆做。
从电子病历中获取信息。根据超声评估或尸检结果将猫分类为存在肾梗死。从接受下一次预定诊断程序的猫中选择时间匹配的病例对照。
600只猫中有309只被诊断为肾梗死,291只为时间匹配的对照。7至14岁的猫患肾梗死的可能性是年轻猫的1.6倍(优势比,95%置信区间:1.03 - 2.05,P = 0.03),但不比老年猫患肾梗死的可能性更高(1.4,0.89 - 2.25,P = 0.14)。所有P = 0.14均具有统计学意义。与无肾梗死的猫相比,有肾梗死的猫患肥厚型心肌病的可能性高4.5倍(优势比,95%置信区间:2.63 - 7.68,P < 0.001)。与无肾梗死的猫相比,有肾梗死的猫被诊断为肿瘤的可能性低0.7倍(优势比,95%置信区间:0.51 - 0.99,P = 0.046)。被诊断为甲状腺功能亢进的猫与患肾梗死无显著关联。与无肾梗死的猫相比,有肾梗死的猫被诊断为远端主动脉血栓栓塞的可能性高8倍(优势比,95%置信区间:2.55 - 25.40,P≤0.001)。
在生前检查中发现有肾梗死的猫应筛查隐匿性心肌病。