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使用口服泼尼松和口服美洛昔康治疗犬特发性淋巴浆细胞性鼻炎的三种治疗方案的评估:一项初步研究。

The evaluation of three treatment protocols using oral prednisone and oral meloxicam for therapy of canine idiopathic lymphoplasmacytic rhinitis: a pilot study.

作者信息

Kaczmar Ewa, Rychlik Andrzej, Szweda Marta

机构信息

Department of Clinical Diagnostics, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 14, 10-957 Olsztyn, Poland.

出版信息

Ir Vet J. 2018 Oct 3;71:19. doi: 10.1186/s13620-018-0131-3. eCollection 2018.

Abstract

BACKGROUND

Idiopathic lymphoplasmacytic rhinitis (LPR) is a common inflammatory disorder of the nasal cavity in dogs due to unknown etiology. It is characterised by non-specific clinical signs, including nasal discharge, epistaxis and breathing problems. Diagnosis is usually based on the histopathologic identification of infiltrating plasmocytes and lymphocytes in the nasal mucosa and the exclusion of other underlying diseases. Treatment strategies include glucocorticoids, non-steroidal anti-inflammatory drugs, antibiotics and antifungal medications. The aim of this study was to evaluate the efficacy of various therapeutic protocols for managing canine lymphoplasmacytic rhinitis based on the results of clinical, endoscopic and histological examinations, and to determine the relapse rate for LPR in dogs.Twenty dogs of different breeds and both sexes, aged 1 to 14 years, were divided into four groups, each consisting of five dogs, including three experimental groups diagnosed with LPR and a control group.The dogs from the first experimental group were administered prednisone orally at 1 mg/kg/day in the first 4 weeks and 0,5 mg/kg/day in the following 2 weeks. The second group of dogs was administered meloxicam orally at 0,1 mg/kg/day in the first 3 weeks, followed by prednisone at 1 mg/kg/day in the following 2 weeks and 0,5 mg/kg/day in the last week of the treatment. The dogs from the third experimental group were administered meloxicam orally at 0,1 mg/kg/day for 6 weeks. The control group of dogs was administered empty gelatin capsules (placebo) orally for 6 weeks. Clinical signs, endoscopic and histopathologic lesions were scored before and after treatment. Groups were compared using Chi- squared statistics in a 2 × 2 table for pre- versus post-treatment scores.

RESULTS

Clinical signs persisted in the group treated with meloxicam and were mostly resolved in prednisone-treated dogs. However, endoscopic and histological changes were still observed in these two groups after treatment. The severity of all diagnostic features was reduced in the group treated with meloxicam for 3 weeks followed by prednisone for 3 weeks. The significant differences ( < 0.05) were noted between experimental and control groups. The dogs showed a statistically significant reduction in characteristics of the LPR before and after treatment, as measured by clinical signs (Group 1vs.4  = 0.00, group 2 vs 4  = 0.00, group 3 vs 4 p = 0,01), by endoscopy (1 vs 4  = 0,01, 2 vs 4  = 0,00, 3 vs 4  = 0,03), and by histopathology (groups 1 vs 4 p = 0,00, 2 vs 4 p = 0,00, 3 vs 4 p = 0,03). The significant differences were noted between experimental groups, as measured by endoscopy (group 2vs 3  = 0,04), and by relapse rate (groups 1 and 2 p = 0,03, groups 2 and 3 p = 0,01).

CONCLUSIONS

The three treatment protocols administered to dogs improved clinical, endoscopic and histological status. However, oral administration of meloxicam for 3 weeks, followed by prednisone for 3 weeks, appeared to be the most successful treatment. These patients remained asymptomatic for 6 months.

摘要

背景

特发性淋巴浆细胞性鼻炎(LPR)是犬鼻腔常见的炎症性疾病,病因不明。其特征为非特异性临床症状,包括鼻分泌物、鼻出血和呼吸问题。诊断通常基于鼻黏膜中浸润的浆细胞和淋巴细胞的组织病理学鉴定以及排除其他潜在疾病。治疗策略包括糖皮质激素、非甾体抗炎药、抗生素和抗真菌药物。本研究的目的是根据临床、内镜和组织学检查结果评估各种治疗方案对犬淋巴浆细胞性鼻炎的疗效,并确定犬LPR的复发率。20只年龄在1至14岁、不同品种和性别的犬被分为四组,每组五只犬,包括三个诊断为LPR的实验组和一个对照组。第一实验组的犬在最初4周口服泼尼松,剂量为1毫克/千克/天,接下来2周为0.5毫克/千克/天。第二组犬在最初3周口服美洛昔康,剂量为0.1毫克/千克/天,随后2周口服泼尼松,剂量为1毫克/千克/天,治疗最后一周为0.5毫克/千克/天。第三实验组的犬口服美洛昔康,剂量为0.1毫克/千克/天,持续6周。对照组的犬口服空明胶胶囊(安慰剂),持续6周。在治疗前后对临床症状、内镜和组织病理学病变进行评分。使用卡方统计在2×2表格中比较治疗前和治疗后的分数对各组进行比较。

结果

用美洛昔康治疗的组临床症状持续存在,而用泼尼松治疗的犬大多症状缓解。然而,治疗后这两组仍观察到内镜和组织学变化。先用美洛昔康治疗3周,后用泼尼松治疗3周的组,所有诊断特征的严重程度均降低。实验组和对照组之间存在显著差异(<0.05)。通过临床症状(第1组与第4组=0.00,第2组与第4组=0.00,第3组与第4组p=0.01)、内镜检查(第1组与第4组=0.01,第2组与第4组=0.00,第3组与第4组=0.03)和组织病理学(第1组与第4组p=0.00,第2组与第4组p=0.00,第3组与第4组p=0.03)测量,犬在治疗前后LPR特征有统计学显著降低。通过内镜检查(第2组与第3组=0.04)和复发率(第1组和第2组p=0.03,第2组和第3组p=0.01)测量,实验组之间存在显著差异。

结论

给予犬的三种治疗方案改善了临床、内镜和组织学状况。然而,口服美洛昔康3周,随后口服泼尼松3周似乎是最成功的治疗方法。这些患者在6个月内无症状。

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