Boshuizen Berit, Ploeg Margreet, Dewulf Jeroen, Klooster Sanne, Bruijn Marco de, Picavet Marie- Thérèse, Palmers Katrien, Plancke Lukas, Cock Hilde De, Theelen Mathijs, Delesalle Catherine
Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Wolvega Equine Clinic, Oldeholtpade, Wolvega, The Netherlands.
BMC Vet Res. 2018 Jan 19;14(1):21. doi: 10.1186/s12917-018-1343-1.
Diagnosing IBD in horses is challenging and requires a multimodal approach, since no conclusive diagnostic test is available. The objectives of this study were to provide an overview of population characteristics, results of applied diagnostic tests, treatment modalities and outcome in a large group of horses thought to have IBD and that were presented to four large equine referral hospitals, and to provide an exploratory investigation of possible associations between results of applied diagnostic tests, applied treatment modalities and outcome. A retrospective case series was performed across four large equine referral hospitals. Seventy-eight horses, thought to have IBD were included. Case history, clinical findings, diagnostic test results including oral glucose tolerance test (OGTT) and enteral biopsies (both duodenal and rectal), applied therapy and outcome were studied. A Chi-Square test was used to identify associations between results of diagnostic tests, treatment and outcome. P-values < 0.05 were considered significant.
Lethargy, diarrhoea, recurrent colic and weight loss were recorded in respectively 21,8%; 14,1%; 28,2% and 78,2% of cases. Over 70% of horses thought to have IBD had an abnormal OGTT. Only weight loss was significantly associated with aberrant enteral biopsy results, but not with abnormal OGTT results or low blood total protein. There was no association between an aberrant biopsy result and a disturbed OGTT. There was no association between either OGTT results or enteral biopsy results and a low blood total protein content, presence of gastric ulcer disease or an aberrant endoscopic aspect of the duodenal entrance.
Weight loss is a highly prevalent symptom in IBD suspected horses. Enteral biopsies may be a useful diagnostic aid in the work-up of horses thought to suffer from IBD, however further research is required to demonstrate their true diagnostic value. Until more standardized scientific research is available, one should be careful with the interpretation of enteral biopsy results There is a need for better standardization of enteral biopsy procedures and the histopathological scoring of biopsies.
由于没有决定性的诊断测试，诊断马的炎症性肠病（IBD）具有挑战性，需要采用多模式方法。本研究的目的是概述一大群被认为患有IBD并被送至四家大型马转诊医院的马的种群特征、应用诊断测试的结果、治疗方式和预后，并对应用诊断测试的结果、应用治疗方式和预后之间的可能关联进行探索性调查。在四家大型马转诊医院进行了一项回顾性病例系列研究。纳入了78匹被认为患有IBD的马。研究病例史、临床发现、诊断测试结果，包括口服葡萄糖耐量试验（OGTT）和肠活检（十二指肠和直肠）、应用的治疗方法和预后。使用卡方检验来确定诊断测试结果、治疗和预后之间的关联。P值<0.05被认为具有统计学意义。
分别有21.8%、14.1%、28.2%和78.2%的病例记录有嗜睡、腹泻、复发性绞痛和体重减轻。超过70%被认为患有IBD的马OGTT异常。只有体重减轻与异常的肠活检结果显著相关，但与OGTT异常结果或低血总蛋白无关。活检结果异常与OGTT异常之间没有关联。OGTT结果或肠活检结果与低血总蛋白含量、胃溃疡疾病的存在或十二指肠入口处异常的内镜表现之间均无关联。
体重减轻是疑似患有IBD的马中非常普遍的症状。肠活检可能是对疑似患有IBD的马进行检查时有用的诊断辅助手段，然而需要进一步研究以证明其真正的诊断价值。在有更多标准化的科学研究之前，对肠活检结果的解释应谨慎。需要更好地规范肠活检程序和活检的组织病理学评分。
