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吸入性类固醇疗法治疗特发性嗜酸性粒细胞性支气管肺炎犬的长期随访

Long-term follow-up in dogs with idiopathic eosinophilic bronchopneumopathy treated with inhaled steroid therapy.

作者信息

Canonne A M, Bolen G, Peeters D, Billen F, Clercx C

机构信息

Department of Small Animal Clinical Sciences, Internal Medicine, Faculty of Veterinary Medicine, University of Liège, Liège 4000, Belgium.

Department of Small Animal Clinical Sciences, Diagnostic Imaging, Faculty of Veterinary Medicine, University of Liège, Liège 4000, Belgium.

出版信息

J Small Anim Pract. 2016 Oct;57(10):537-542. doi: 10.1111/jsap.12529. Epub 2016 Jul 28.

Abstract

BACKGROUND

Treatment of canine idiopathic eosinophilic bronchopneumopathy mainly consists of long-term oral corticosteroid therapy. To avoid side effects, inhaled steroid therapy has been increasingly used but long-term clinical response and potential side effects are sparsely described.

OBJECTIVES

Description of clinical response and side effects with long-term fluticasone in dogs with eosinophilic bronchopneumopathy.

METHODS

Case series of dogs with eosinophilic bronchopneumopathy and treated with fluticasone monotherapy for at least 6 months. Clinical response and side effects assessed by physical examination, standardised questionnaire and ACTH (corticotropin) stimulation test.

RESULTS

Eight dogs were treated for between 6 months and 5 years. Cough initially improved in all dogs; two dogs remained free of clinical signs, three were well controlled, but three showed severe relapse. Pituitary-adrenal axis inhibition occurred in two dogs treated with fluticasone monotherapy for more than 2 years; only one dog had clinical signs of iatrogenic hyperadrenocorticism.

CLINICAL SIGNIFICANCE

Fluticasone monotherapy allows initial improvement or remission in the majority of dogs but long-term treatment fails to resolve the cough in some individuals. In addition, such therapy may induce pituitary-adrenal axis inhibition. Prospective larger and randomised studies including both fluticasone and orally-treated dogs are needed to define the optimal treatment.

摘要

背景

犬特发性嗜酸性粒细胞性支气管肺炎的治疗主要包括长期口服皮质类固醇疗法。为避免副作用,吸入性类固醇疗法的使用日益增加,但长期临床反应和潜在副作用的描述却很少。

目的

描述长期使用氟替卡松治疗嗜酸性粒细胞性支气管肺炎犬的临床反应和副作用。

方法

对嗜酸性粒细胞性支气管肺炎犬进行病例系列研究,采用氟替卡松单一疗法治疗至少6个月。通过体格检查、标准化问卷和促肾上腺皮质激素(ACTH)刺激试验评估临床反应和副作用。

结果

8只犬接受了6个月至5年的治疗。所有犬的咳嗽最初均有所改善;2只犬无临床症状,3只得到良好控制,但3只出现严重复发。接受氟替卡松单一疗法治疗超过2年的2只犬出现垂体-肾上腺轴抑制;只有1只犬有医源性肾上腺皮质功能亢进的临床症状。

临床意义

氟替卡松单一疗法可使大多数犬最初病情改善或缓解,但长期治疗无法使一些犬的咳嗽得到解决。此外,这种疗法可能会导致垂体-肾上腺轴抑制。需要进行包括氟替卡松治疗犬和口服治疗犬的前瞻性、更大规模的随机研究,以确定最佳治疗方法。

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