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糖皮质激素单一疗法治疗犬特发性脑膜脑脊髓炎的疗效:16只犬的前瞻性研究

Efficacy of glucocorticoid monotherapy for treatment of canine meningoencephalomyelitis of unknown etiology: a prospective study in 16 dogs.

作者信息

Mercier Miyu, Barnes Heller Heidi L

机构信息

VCA Aurora Animal Hospital2600 West Galena BlvdAuroraIllinois60506USA.

出版信息

Vet Med Sci. 2015 Jun 29;1(1):16-22. doi: 10.1002/vms3.4. eCollection 2015 Jul.

Abstract

Canine non-infectious, inflammatory meningoencephalomyelitis is termed meningoencephalomyelitis of unknown etiology (MUE) and may affect dogs of any age, breed or gender. Treatment with immunosuppressive medication has been widely reported, however no prospective clinical trials with a standard glucocorticoid monotherapy are available. The objectives were to compare the cerebrospinal fluid (CSF) analysis at diagnosis and after treatment with a standard glucocorticoid (GC) dose and to determine the survival time in dogs with MUE. We hypothesized that abnormal CSF findings would normalize in dogs with MUE, and survival time would be longer than previously reported for glucocortocoid therapy alone. Inclusion criteria were: (1) normal minimum database, (2) no GC use within 5 days, (3) magnetic resonance imaging performed, (4) negative infectious disease titres, and (5) abnormal CSF analysis. All dogs received GC therapy at 1 mg/kg q 12 h. Responders had normal CSF analysis at 1 month. Sixteen dogs met the inclusion criteria. Median total nucleated cell count (TNCC) and protein concentration at time of diagnosis were 39 cells/L (0-1400 cells/L), and 49 mg/dL (25-293 mg/dL), respectively. Median TNCC and protein concentration at 1 month were 1 cell/L (0-120 cells/L), and 24 mg/dL (13-175 mg/dL), respectively. Seven of 16 dogs (44%) were responders. There was no significant difference in survival between the CSF responders and CSF non-responders ( = 0.85). Overall median survival was 602 days (45-654 days). This study supports using GC therapy in dogs with MUE.

摘要

犬非感染性炎性脑膜脑脊髓炎被称为病因不明的脑膜脑脊髓炎(MUE),可影响任何年龄、品种或性别的犬。免疫抑制药物治疗已有广泛报道,但尚无标准糖皮质激素单一疗法的前瞻性临床试验。目的是比较诊断时和标准糖皮质激素(GC)剂量治疗后的脑脊液(CSF)分析,并确定MUE犬的存活时间。我们假设MUE犬的脑脊液异常结果会恢复正常,且存活时间会比之前单独使用糖皮质激素治疗的报道更长。纳入标准为:(1)最小数据库正常,(2)5天内未使用GC,(3)进行了磁共振成像,(4)传染病滴度为阴性,(5)脑脊液分析异常。所有犬均接受1mg/kg q 12h的GC治疗。有反应者在1个月时脑脊液分析正常。16只犬符合纳入标准。诊断时的总核细胞计数(TNCC)中位数和蛋白质浓度分别为39个细胞/L(0 - 1400个细胞/L)和49mg/dL(25 - 293mg/dL)。1个月时的TNCC中位数和蛋白质浓度分别为1个细胞/L(0 - 120个细胞/L)和24mg/dL(13 - 175mg/dL)。16只犬中有7只(44%)有反应。脑脊液有反应者和无反应者的存活情况无显著差异(= 0.85)。总体中位存活时间为602天(45 - 654天)。本研究支持对MUE犬使用GC治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e2e/5645807/5beb5b02f0b1/VMS3-1-16-g001.jpg

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