测定犬血清C反应蛋白浓度以鉴别化脓性关节炎和骨关节炎。
Measurement of serum C-reactive protein concentration for discriminating between suppurative arthritis and osteoarthritis in dogs.
作者信息
Hillström Anna, Bylin Jonas, Hagman Ragnvi, Björhall Karin, Tvedten Harold, Königsson Kristian, Fall Tove, Kjelgaard-Hansen Mads
机构信息
Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Evidensia Södra Djursjukhuset, Stockholm, Sweden.
出版信息
BMC Vet Res. 2016 Oct 28;12(1):240. doi: 10.1186/s12917-016-0868-4.
BACKGROUND
In a dog with joint pain, it is important to determine whether it has suppurative joint disease, characterized by exudation of neutrophils in the synovial fluid, or not, as this affects choice of diagnostic tests and treatments. The aim of this study was to evaluate whether measurement of serum C-reactive protein (CRP) concentration could be used to discriminate between dogs with suppurative arthritis and osteoarthritis (OA). Furthermore, the concentrations of serum and synovial fluid interleukin (IL) 6 concentrations were measured in dogs with joint disease and in healthy dogs, and were correlated to serum CRP concentrations.
METHODS
Dogs with joint pain were enrolled prospectively and were classified to have suppurative arthritis or OA based on synovial fluid analysis and radiographic/arthroscopic findings. Healthy Beagles were enrolled as a comparative group. CRP and IL-6 concentrations were measured with canine-specific immunoassays. The performance of CRP concentration in discriminating between dogs with suppurative arthritis and OA was evaluated using a previously established clinical decision limit for CRP (20 mg/l), and by receiver operator characteristic (ROC) curve and logistic regression analysis. Comparisons of CRP and IL-6 concentrations between groups were performed using t-tests, and correlations by Spearman rank correlation coefficients.
RESULTS
Samples were obtained from 31 dogs with suppurative arthritis, 34 dogs with OA, and 17 healthy dogs. Sixty-two out of 65 dogs with joint disease were correctly classified using the clinical decision limit for CRP. Evaluation of ROC curve and regression analysis indicated that serum CRP concentrations could discriminate between suppurative arthritis and OA. Dogs with suppurative arthritis had higher serum CRP and serum and synovial fluid IL-6 concentrations compared to dogs with OA (p < 0.001). Dogs with OA had higher synovial fluid IL-6 concentrations (p < 0.001), but not higher serum CRP (p = 0.29) or serum IL-6 (p = 0.07) concentrations, compared to healthy dogs. There was a positive correlation between synovial fluid IL-6 and serum CRP concentrations (r = 0.733, p < 0.001), and between serum IL-6 and serum CRP concentrations (r = 0.729, p < 0.001).
CONCLUSION
CRP concentration was found to discriminate well between dogs with suppurative arthritis and OA.
背景
对于患有关节疼痛的犬只，确定其是否患有以滑液中嗜中性粒细胞渗出为特征的化脓性关节疾病非常重要，因为这会影响诊断测试和治疗方法的选择。本研究的目的是评估血清C反应蛋白（CRP）浓度的测量是否可用于区分患有化脓性关节炎和骨关节炎（OA）的犬只。此外，还测量了患有关节疾病的犬只和健康犬只的血清和滑液白细胞介素（IL）-6浓度，并将其与血清CRP浓度进行关联分析。
方法
前瞻性纳入患有关节疼痛的犬只，并根据滑液分析及影像学/关节镜检查结果将其分类为患有化脓性关节炎或OA。纳入健康比格犬作为对照组。使用犬特异性免疫测定法测量CRP和IL-6浓度。使用先前确定的CRP临床决策限（20mg/l）、受试者工作特征（ROC）曲线和逻辑回归分析评估CRP浓度在区分化脓性关节炎和OA犬只中的性能。使用t检验进行组间CRP和IL-6浓度的比较，并使用Spearman等级相关系数进行相关性分析。
结果
从31只患有化脓性关节炎的犬只、34只患有OA的犬只和17只健康犬只中获取样本。使用CRP临床决策限，65只患有关节疾病的犬只中有62只被正确分类。ROC曲线评估和回归分析表明，血清CRP浓度可区分化脓性关节炎和OA。与患有OA的犬只相比，患有化脓性关节炎的犬只血清CRP、血清和滑液IL-6浓度更高（p<0.001）。与健康犬只相比，患有OA的犬只滑液IL-6浓度更高（p<0.001），但血清CRP（p=0.29）或血清IL-6（p=0.07）浓度并不更高。滑液IL-6与血清CRP浓度之间（r=0.733，p<0.001）以及血清IL-6与血清CRP浓度之间（r=0.729，p<0.001）存在正相关。
结论
发现CRP浓度能够很好地区分患有化脓性关节炎和OA的犬只。
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