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急性期蛋白在评估犬细菌性肺炎治疗反应中的应用

The Utility of Acute-Phase Proteins in the Assessment of Treatment Response in Dogs With Bacterial Pneumonia.

作者信息

Viitanen S J, Lappalainen A K, Christensen M B, Sankari S, Rajamäki M M

机构信息

Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.

Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Vet Intern Med. 2017 Jan;31(1):124-133. doi: 10.1111/jvim.14631. Epub 2016 Dec 29.

Abstract

BACKGROUND

Acute-phase proteins (APPs) are sensitive markers of inflammation, and serum C-reactive protein (CRP) recently has been shown to be a useful diagnostic marker in dogs with bacterial pneumonia (BP). In humans with community-acquired pneumonia, APPs also have great utility as follow-up markers aiding in the assessment of treatment response.

OBJECTIVES

The aim of our study was to investigate the applicability of APPs as markers of treatment response in dogs with BP.

ANIMALS

Nineteen dogs diagnosed with BP and 64 healthy dogs.

METHODS

The study was conducted as a prospective longitudinal observational study. Serum CRP, serum amyloid A (SAA), and haptoglobin concentrations were followed during a natural course of BP. Normalization of serum CRP was used to guide the duration of antibiotic treatment (treatment was stopped 5-7 days after CRP normalized) in 8 of 17 dogs surviving to discharge; 9 of 17 dogs were treated according to conventional recommendations.

RESULTS

All measured APPs initially were significantly increased, but the magnitude of increase was not correlated to disease severity. C-reactive protein and SAA concentrations decreased rapidly after initiation of antimicrobial treatment. When normalization of serum CRP was used to guide the duration of antibiotic treatment, treatment duration was significantly (P = .015) decreased without increasing the number of relapses.

CONCLUSIONS AND CLINICAL IMPORTANCE

Serum CRP and SAA reflected the recovery process well and therefore may be used as markers of treatment response. According to the results, the normalization of serum CRP may be used to guide the duration of antibiotic treatment in dogs with BP.

摘要

背景

急性期蛋白(APPs)是炎症的敏感标志物,近期研究表明血清C反应蛋白(CRP)是犬细菌性肺炎(BP)的一种有用诊断标志物。在社区获得性肺炎患者中,APPs作为辅助评估治疗反应的随访标志物也具有很大用途。

目的

本研究旨在调查APPs作为犬BP治疗反应标志物的适用性。

动物

19只诊断为BP的犬和64只健康犬。

方法

本研究作为一项前瞻性纵向观察性研究开展。在BP自然病程中监测血清CRP、血清淀粉样蛋白A(SAA)和触珠蛋白浓度。17只存活至出院的犬中有8只根据血清CRP恢复正常来指导抗生素治疗疗程(CRP恢复正常后5 - 7天停止治疗);17只犬中的9只按照传统建议进行治疗。

结果

所有检测的APPs最初均显著升高,但升高幅度与疾病严重程度无关。抗菌治疗开始后,C反应蛋白和SAA浓度迅速下降。当用血清CRP恢复正常来指导抗生素治疗疗程时,治疗疗程显著缩短(P = 0.015)且复发次数未增加。

结论及临床意义

血清CRP和SAA能很好地反映恢复过程,因此可用作治疗反应标志物。根据研究结果,血清CRP恢复正常可用于指导犬BP的抗生素治疗疗程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ced/5259651/2fe73bf13b86/JVIM-31-124-g001.jpg

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