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具有食物反应性蛋白丢失性肠病的犬的临床特征。

Clinical characteristics of dogs with food-responsive protein-losing enteropathy.

机构信息

Laboratory of Veterinary Internal Medicine, Department of Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

出版信息

J Vet Intern Med. 2020 Mar;34(2):659-668. doi: 10.1111/jvim.15720. Epub 2020 Feb 15.

Abstract

BACKGROUND

In dogs with protein-losing enteropathy (PLE), data on the clinical characteristics of food-responsive PLE (FR-PLE) remain scarce.

OBJECTIVE

To determine the clinical characteristics of FR-PLE in dogs responsive to ultralow-fat diet (ULFD) management.

ANIMALS

Thirty-three dogs diagnosed with PLE based on standard diagnostic criteria.

METHODS

Retrospective review of medical records. Clinical findings were compared between dogs with FR-PLE (FR-PLE group) and those with immunosuppressant-responsive PLE (IR-PLE) or nonresponsive PLE (NR-PLE) (IR/NR-PLE group). The area under the curve (AUC) of a receiver operating characteristic curve was used to evaluate the ability of factors to differentiate the FR-PLE and IR/NR-PLE groups. Survival time was compared between the FR-PLE and IR/NR-PLE groups.

RESULTS

Twenty-three dogs responded to ULFD management and were diagnosed with FR-PLE. The canine chronic enteropathy clinical activity index (CCECAI) was significantly lower in the FR-PLE group than in the IR/NR-PLE group (P < .001). The AUC of CCECAI for differentiating the FR-PLE group was 0.935 (95% confidence interval [CI], 0.845-1.000) with an optimal cutoff value of 8 (sensitivity, 0.826; specificity, 0.889). Survival times were significantly longer in the FR-PLE group (median, not reached) than in the IR/NR-PLE group (median, 432 days; P < .001).

CONCLUSIONS AND CLINICAL IMPORTANCE

Dogs that respond to ULFD management and are diagnosed with FR-PLE are expected to have a favorable prognosis. Clinical scores, specifically the CCECAI, could be useful for differentiating FR-PLE from IR-PLE or NR-PLE.

摘要

背景

在患有蛋白丢失性肠病(PLE)的犬中,针对对低脂饮食(ULFD)有反应的 PLE(FR-PLE)的临床特征的数据仍然有限。

目的

确定对 ULFD 管理有反应的 FR-PLE 犬的临床特征。

动物

根据标准诊断标准诊断为 PLE 的 33 只犬。

方法

回顾性病历审查。比较 FR-PLE 犬(FR-PLE 组)与免疫抑制剂反应性 PLE(IR-PLE)或无反应性 PLE(NR-PLE)犬(IR/NR-PLE 组)的临床发现。接收器操作特征曲线的曲线下面积(AUC)用于评估区分 FR-PLE 和 IR/NR-PLE 组的因素的能力。比较 FR-PLE 和 IR/NR-PLE 组之间的生存时间。

结果

23 只犬对 ULFD 管理有反应,被诊断为 FR-PLE。FR-PLE 组的犬慢性肠病临床活动指数(CCECAI)明显低于 IR/NR-PLE 组(P <.001)。区分 FR-PLE 组的 CCECAI 的 AUC 为 0.935(95%置信区间[CI],0.845-1.000),最佳截断值为 8(敏感性,0.826;特异性,0.889)。FR-PLE 组的生存时间明显长于 IR/NR-PLE 组(中位数,未达到)(中位数,432 天;P <.001)。

结论和临床意义

对 ULFD 管理有反应并被诊断为 FR-PLE 的犬预计具有良好的预后。临床评分,特别是 CCECAI,可用于区分 FR-PLE 与 IR-PLE 或 NR-PLE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d6d/7096654/74041266a684/JVIM-34-659-g001.jpg

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