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用于评估禽类肝脏疾病的血浆生化、血液学、影像学和内镜可视化检查的诊断价值。

Diagnostic value of plasma biochemistry, haematology, radiography and endoscopic visualisation for hepatic disease in psittacine birds.

机构信息

Department of Small Animal Medicine and Surgery (Zoological Medicine), University of Georgia College of Veterinary Medicine, Athens, Georgia, USA.

Department of Small Animal Medicine and Surgery (Zoological Medicine), University of Georgia College of Veterinary Medicine, Athens, Georgia, USA

出版信息

Vet Rec. 2020 May 30;186(17):563. doi: 10.1136/vr.105214. Epub 2019 Nov 20.

Abstract

BACKGROUND

Hepatic disease in psittacine birds is common but challenging to diagnose. This retrospective study evaluates the diagnostic value of plasma biochemistry, haematology, radiography and endoscopic visualisation in psittaciforms with suspected hepatic disease that underwent endoscopic liver biopsy.

METHODS

Clinical records of 28 companion psittaciforms from a veterinary teaching hospital (2007-2016) were reviewed. Diagnostic results were categorised as abnormal or normal and compared with histopathology for agreement or disagreement. Statistical significance was determined by kappa test for agreement and McNemar's test for disagreement.

RESULTS

11 of 28 psittaciforms (39.3 per cent) had clinical signs considered specific for liver disease. 25 of 28 (89.3 per cent) psittaciforms had histopathological liver lesions. Gross changes radiographically and endoscopically agreed with histopathology in 57.1 per cent and 53.6 per cent of cases, respectively. Aspartate aminotransferase (AST) (48.1 per cent), creatine phosphokinase (73.1 per cent) and albumin by protein electrophoresis (50 per cent) showed the highest agreement. Kappa was not significant for any parameters, while McNemar's test for disagreement was significant for radiography, endoscopy, AST, lactate dehydrogenase, bile acid, total protein (chemistry), cholesterol, triglycerides, uric acid and glucose.

CONCLUSION

Overall, changes on plasma biochemistry, radiography or endoscopy are non-specific and do not consistently agree with histopathology results. Endoscopic liver biopsy is highly recommended if there is clinical suspicion of hepatic disease.

摘要

背景

禽类的肝病很常见,但诊断具有挑战性。本回顾性研究评估了怀疑患有肝病的凤头鹦鹉进行内镜肝活检时,血浆生化、血液学、放射学和内镜可视化检查的诊断价值。

方法

回顾了一家兽医教学医院(2007-2016 年)28 只伴侣凤头鹦鹉的临床记录。将诊断结果分为异常或正常,并与组织病理学结果进行一致性比较。通过 Kappa 检验评估一致性,McNemar 检验评估不一致性。

结果

28 只凤头鹦鹉中有 11 只(39.3%)出现了被认为是肝脏疾病特异性的临床症状。28 只凤头鹦鹉中有 25 只(89.3%)有组织病理学肝脏病变。放射学和内镜下的大体变化与组织病理学结果的一致性分别为 57.1%和 53.6%。天冬氨酸转氨酶(AST)(48.1%)、肌酸磷酸激酶(CPK)(73.1%)和白蛋白电泳(50%)显示出最高的一致性。任何参数的 Kappa 均不显著,而放射学、内镜、AST、乳酸脱氢酶、胆汁酸、总蛋白(化学)、胆固醇、甘油三酯、尿酸和葡萄糖的 McNemar 检验差异显著。

结论

总体而言,血浆生化、放射学或内镜下的变化是非特异性的,并不总是与组织病理学结果一致。如果临床怀疑有肝脏疾病,强烈建议进行内镜肝活检。

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