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血液中性粒细胞与淋巴细胞比值(NLR)作为慢性肠炎犬的诊断标志物。

Blood neutrophil-to-lymphocyte ratio (NLR) as a diagnostic marker in dogs with chronic enteropathy.

机构信息

Department for Small Animals, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany.

Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.

出版信息

J Vet Diagn Invest. 2021 May;33(3):516-527. doi: 10.1177/1040638721992057. Epub 2021 Feb 8.

Abstract

Few routinely available biomarkers are clinically useful in assessing dogs with chronic enteropathy (CE) and aid in CE subclassification. The diagnostic potential of the blood neutrophil-to-lymphocyte ratio (NLR) has not been evaluated in canine CE. We evaluated the NLR in 93 dogs with CE (no steroid treatment for ≥2 wk prior) and tested for an association with clinical, clinicopathologic, and histologic characteristics and also with CE subclassification. NLR was significantly higher in CE dogs with severe clinical disease than dogs with mild clinical disease ( = 0.047). Hypoalbuminemia ( < 0.001), but not hypocobalaminemia, was associated with higher NLRs. NLR was correlated with fecal alpha-proteinase inhibitor concentrations (ρ = 0.47) and the serum-to-fecal alpha-proteinase inhibitor ratio (ρ = -0.48; both  < 0.001) but not with serum or fecal inflammatory markers nor with the overall histologic score (all  > 0.05). Dogs with steroid- or other immunosuppressant-responsive (IRE) or nonresponsive enteropathy (NRE) had significantly higher NLRs (median: 7.3) than dogs with food-responsive enteropathy (FRE; median: 3.0;  = 0.003), and a NLR ≥5.5 best distinguished both groups of dogs. No difference in NLR was detected between dogs with IRE and dogs diagnosed with NRE. These findings suggest that leukogram changes (i.e., NLR) could be clinically useful in canine CE, and that neutrophils might play a role in the systemic inflammatory response associated with canine CE. The NLR can be easily assessed on routine hematology and can potentially aid in the subclassification of dogs with CE based on the response to treatment.

摘要

在评估患有慢性肠炎(CE)的犬时,很少有常规可用的生物标志物具有临床实用性,并有助于 CE 的细分。血液中性粒细胞与淋巴细胞比值(NLR)在犬 CE 中的诊断潜力尚未得到评估。我们评估了 93 只患有 CE(在进行类固醇治疗前≥2 周未进行类固醇治疗)的犬的 NLR,并检测了其与临床、临床病理和组织学特征的相关性,以及与 CE 细分的相关性。患有严重临床疾病的 CE 犬的 NLR 明显高于患有轻度临床疾病的犬(=0.047)。低白蛋白血症(<0.001),而不是低钴胺素血症,与较高的 NLR 相关。NLR 与粪便α-蛋白酶抑制剂浓度(ρ=0.47)和血清-粪便α-蛋白酶抑制剂比值(ρ=-0.48;均<0.001)相关,但与血清或粪便炎症标志物或整体组织学评分均不相关(均>0.05)。具有类固醇或其他免疫抑制剂反应性(IRE)或无反应性肠炎(NRE)的犬的 NLR 明显高于具有食物反应性肠炎(FRE)的犬(中位数:7.3;=0.003),NLR≥5.5 可最佳区分两组犬。IRE 犬和诊断为 NRE 的犬之间的 NLR 无差异。这些发现表明,白细胞计数变化(即 NLR)可能在犬 CE 中具有临床实用性,并且中性粒细胞可能在与犬 CE 相关的全身炎症反应中发挥作用。NLR 可以在常规血液学检查中轻松评估,并可能有助于根据治疗反应对 CE 犬进行细分。

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