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免疫介导性溶血性贫血犬血浆平均血小板成分浓度的病例对照研究及生存分析

Case-control study of plasma mean platelet component concentration and survival analysis for dogs with immune-mediated hemolytic anemia.

作者信息

Zoia Andrea, Gerou-Ferriani Magda, Drigo Michele, Caldin Marco

出版信息

J Am Vet Med Assoc. 2018 Jun 1;252(11):1384-1392. doi: 10.2460/javma.252.11.1384.

Abstract

OBJECTIVE To determine whether dogs with immune-mediated hemolytic anemia (IMHA) had a low plasma mean platelet component (MPC) concentration and whether MPC was associated with outcome. DESIGN Retrospective case-control study and survival analysis. ANIMALS 95 dogs with IMHA (cases) as well as 95 healthy dogs and 95 sick dogs without IMHA (controls) matched to cases by age, reproductive status, and breed. PROCEDURES Plasma MPC concentration at initial examination was compared among groups. For dogs with IMHA only, sex, age, serum urea and bilirubin concentrations, Hct, platelet count, and plasma fibrinogen, D-dimer, and MPC concentrations were evaluated for associations with survival to 42 days after initial examination. RESULTS Plasma MPC concentration was significantly lower in dogs with IMHA than in the other 2 dog groups. In dogs with IMHA, plasma MPC concentration was the only factor significantly associated with outcome. The optimal plasma MPC concentration cutoff value for predicting nonsurvival of dogs with IMHA was 19.1 g/dL; values ≤ 19.1 g/dL were associated with nonsurvival. Likewise, the survival curve for dogs with plasma MPC concentrations ≤ 19.1 g/dL differed significantly from that for dogs with values > 19.1 g/dL. The mean estimated risk of death for dogs with IMHA decreased by 16% for every unit increase in plasma MPC concentration. CONCLUSIONS AND CLINICAL RELEVANCE In dogs with IMHA, platelets appeared to have been activated to a greater degree, as determined by lower plasma MPC concentrations, than in healthy dogs or sick dogs without IMHA. Plasma MPC concentration at initial examination may be useful for predicting prognosis in dogs with IMHA.

摘要

目的 确定免疫介导性溶血性贫血(IMHA)犬的血浆平均血小板成分(MPC)浓度是否较低,以及MPC是否与预后相关。 设计 回顾性病例对照研究和生存分析。 动物 95只患有IMHA的犬(病例组)以及95只健康犬和95只无IMHA的患病犬(对照组),对照组在年龄、生殖状态和品种方面与病例组相匹配。 方法 比较各组初次检查时的血浆MPC浓度。仅针对患有IMHA的犬,评估性别、年龄、血清尿素和胆红素浓度、血细胞比容、血小板计数以及血浆纤维蛋白原、D-二聚体和MPC浓度与初次检查后42天存活情况的相关性。 结果 患有IMHA的犬的血浆MPC浓度显著低于其他两组犬。在患有IMHA的犬中,血浆MPC浓度是唯一与预后显著相关的因素。预测患有IMHA的犬无法存活的最佳血浆MPC浓度临界值为19.1 g/dL;≤19.1 g/dL的值与无法存活相关。同样,血浆MPC浓度≤19.1 g/dL的犬的生存曲线与>19.1 g/dL的犬的生存曲线有显著差异。患有IMHA的犬的血浆MPC浓度每增加一个单位,平均估计死亡风险降低16%。 结论及临床意义 与健康犬或无IMHA的患病犬相比,通过较低的血浆MPC浓度确定,患有IMHA的犬的血小板似乎被激活的程度更高。初次检查时的血浆MPC浓度可能有助于预测患有IMHA的犬的预后。

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