Haworth Mark D, Hosgood Giselle, Swindells Katrin L, Mansfield Caroline S
School of Veterinary and Biomedical Sciences, Murdoch University, Perth, Western Australia, Australia.
J Vet Emerg Crit Care (San Antonio). 2014 Mar-Apr;24(2):135-43. doi: 10.1111/vec.12158.
To (i) assess the clinical diagnostic accuracy of SNAP canine pancreatic lipase (cPL) and specific canine pancreatic lipase (Spec cPL) and (ii) assess the agreement of an abnormal test result between SNAP cPL and Spec cPL in dogs presenting with acute abdominal disease.
Prospective observational cohort study.
University teaching hospital emergency center.
Thirty-eight client-owned dogs that presented with acute abdominal disease, with a known final diagnosis between March 2009 and April 2010. Dogs were retrospectively assigned into 2 groups, dogs with acute pancreatitis (AP) (Group 1) and dogs without AP (Group 2).
Paired serum samples obtained within 24 hours of presentation were analyzed using the SNAP cPL test and Spec cPL assay.
SNAP cPL clinical sensitivity and specificity was 82% (9/11 dogs of group 1) and 59% (16/27 dogs of group 2), respectively. Spec cPL clinical sensitivity and specificity was 70% (7/10 dogs of group 1) and 77% (20/26 dogs of group 2), respectively. Accuracy of the SNAP and Spec cPL for a clinical diagnosis of pancreatitis was found to be 66% and 75%, respectively. Agreement between a positive SNAP (cPL ≥ 200 μg/L) and a clinical diagnosis pancreatitis resulted in κ = 0.33. Agreement between an increased Spec (cPL ≥ 400 μg/L) and a clinical diagnosis of pancreatitis resulted in a κ = 0.43. The agreement between SNAP and Spec cPL (cPL ≥ 200 μg/L) for the entire cohort resulted in κ = 0.78.
SNAP cPL and Spec cPL results may provide a "false positive" diagnosis of pancreatitis in up to 40% of dogs presenting with acute abdominal disease. There is good overall agreement between SNAP cPL and Spec cPL; however, there were 4/38 dogs with positive SNAP cPL and "normal" Spec cPL.
(i)评估SNAP犬胰脂肪酶（cPL）和特异性犬胰脂肪酶（Spec cPL）的临床诊断准确性；(ii)评估患有急性腹部疾病的犬中，SNAP cPL和Spec cPL检测结果异常之间的一致性。
前瞻性观察队列研究。
大学教学医院急诊科。
38只客户拥有的患有急性腹部疾病的犬，其最终诊断明确，时间为2009年3月至2010年4月。犬被回顾性分为2组，急性胰腺炎（AP）犬（第1组）和非AP犬（第2组）。
在就诊24小时内采集的配对血清样本，使用SNAP cPL检测和Spec cPL检测进行分析。
SNAP cPL的临床敏感性和特异性分别为82%（第1组11只犬中的9只）和59%（第2组27只犬中的16只）。Spec cPL的临床敏感性和特异性分别为70%（第1组10只犬中的7只）和77%（第2组26只犬中的20只）。发现SNAP和Spec cPL对胰腺炎临床诊断的准确性分别为66%和75%。SNAP阳性（cPL≥200μg/L）与胰腺炎临床诊断之间的一致性导致κ=0.33。Spec升高（cPL≥400μg/L）与胰腺炎临床诊断之间的一致性导致κ=0.43。整个队列中SNAP和Spec cPL（cPL≥200μg/L）之间的一致性导致κ=0.78。
SNAP cPL和Spec cPL结果可能会在高达40%的患有急性腹部疾病的犬中对胰腺炎做出“假阳性”诊断。SNAP cPL和Spec cPL之间总体一致性良好；然而，38只犬中有4只SNAP cPL阳性而Spec cPL“正常”。
