患有肝脏疾病马匹的血清胆汁酸浓度、组织病理学特征以及短期和长期生存率。

Serum bile acid concentrations, histopathological features, and short-, and long-term survival in horses with hepatic disease.

作者信息

Dunkel B, Jones S A, Pinilla M J, Foote A K

机构信息

Department of Clinical Science and Services, Royal Veterinary College, North Mymms, UK.

出版信息

J Vet Intern Med. 2015 Mar-Apr;29(2):644-50. doi: 10.1111/jvim.12551.

DOI:10.1111/jvim.12551

PMID:25818219

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4895510/

Abstract

BACKGROUND

Serum bile acid concentrations (SBA) and a histopathological biopsy score [Equine Vet J 35 (2003) 534] are used prognostically in equine hepatic disease.

HYPOTHESIS

Histopathologic features and scores, but not SBA, differ between survivors and nonsurvivors and correlate with histopathologic evidence of hepatic inflammation and fibrosis.

ANIMALS

Retrospective study. Records (1999-2011) of horses with hepatic disease diagnosed by biopsy and with concurrent measurements of SBA.

METHODS

Retrospective cohort study. Biopsies were examined for inflammatory cell infiltration including type and distribution, fibrosis, irreversible cytopathology affecting hepatocytes, hemosiderin, or other pigment deposition and bile duct proliferation. SBA, histopathological findings and a histological score [Equine Vet J 35 (2003) 534] were compared between short- (survival to discharge) and long-term (>6 months) survivors and correlations between SBA and histopathological findings investigated.

RESULTS

Of 81 cases 90% survived short-term and 83% long-term. Short-term and long-term nonsurvival were associated with SBA (P = .009; P = .006), overall (P = .001; P = .002) and parenchymal (short-term only; P = .01) inflammation, portal and bridging fibrosis (all P < .001), apoptosis or single cell necrosis (P < .001; P = .008), hemosiderin deposition in hepatocytes (P = .011; P = .028), biliary (both P < .001), vascular (P = .003; P = .045) and endothelial (P < .001; P = .02) hyperplasia, nucleic changes (P = .004; P < .001) and the histopathological score (both P < .001). SBA were significantly and positively correlated with overall (P = .001), parenchymal (P < .001) and portal (P = .004) inflammation and portal (P = .036) and bridging (P = .002) fibrosis.

CONCLUSIONS AND CLINICAL IMPORTANCE

SBA, histopathological findings and scores differ between survivors and nonsurvivors. SBA concentrations are associated with inflammation and fibrosis suggesting interference with hepatic function. A histopathological score >2 and, less so, SBA >20 μmol/L are specific but not sensitive indicators of nonsurvival.

摘要

背景

血清胆汁酸浓度（SBA）和组织病理学活检评分[《马兽医杂志》35（2003）534]用于马肝脏疾病的预后评估。

假设

存活者和非存活者之间的组织病理学特征和评分存在差异，但SBA无差异，且与肝脏炎症和纤维化的组织病理学证据相关。

动物

回顾性研究。收集1999 - 2011年经活检诊断为肝脏疾病并同时测量SBA的马匹记录。

方法

回顾性队列研究。检查活检组织中的炎性细胞浸润情况，包括类型和分布、纤维化、影响肝细胞的不可逆细胞病理学变化、含铁血黄素或其他色素沉积以及胆管增生。比较短期（存活至出院）和长期（>6个月）存活者之间的SBA、组织病理学发现和组织学评分[《马兽医杂志》35（2003）534]，并研究SBA与组织病理学发现之间的相关性。

结果

81例病例中，90%短期存活，83%长期存活。短期和长期死亡与SBA（P = 0.009；P = 0.006）、总体（P = 0.001；P = 0.002）和实质（仅短期；P = 0.01）炎症、门静脉和桥接纤维化（所有P < 0.001）、凋亡或单细胞坏死（P < 0.001；P = 0.008）、肝细胞内含铁血黄素沉积（P = 0.011；P = 0.028）、胆管（两者P < 0.001）、血管（P = 0.003；P = 0.045）和内皮（P < 0.001；P = 0.02）增生、细胞核变化（P = 0.004；P < 0.001）以及组织病理学评分（两者P < 0.001）有关。SBA与总体（P = 0.001）、实质（P < 0.001）和门静脉（P = 0.004）炎症以及门静脉（P = 0.036）和桥接（P = 0.002）纤维化显著正相关。