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英国初级兽医护理下犬类肾上腺皮质功能减退症:发病率、临床治疗方法及风险因素

Hypoadrenocorticism in dogs under UK primary veterinary care: frequency, clinical approaches and risk factors.

作者信息

Schofield I, Woolhead V, Johnson A, Brodbelt D C, Church D B, O'Neill D G

机构信息

Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts, AL9 7TA, UK.

Eastcott Referrals, Edison Park, Dorcan Way, Swindon, SN3 3RB, UK.

出版信息

J Small Anim Pract. 2021 May;62(5):343-350. doi: 10.1111/jsap.13285. Epub 2021 Feb 8.

Abstract

OBJECTIVES

To estimate the frequency, clinical approaches and risk factors of hypoadrenocorticism in dogs under UK primary veterinary care.

MATERIALS AND METHODS

Dogs diagnosed with hypoadrenocorticism were identified from the UK VetCompass™ programme by searching anonymised electronic patient records. Pre-existing and newly diagnosed cases of disease during 2016 were included. Cases were further sub-categorised as having a laboratory-confirmed or presumed diagnosis of hypoadrenocorticism based on the information recorded in the electronic patient records. Descriptive data were manually extracted. Multivariable logistic regression methods were used to identify demographic risk factors.

RESULTS

There were 177 hypoadrenocorticism cases identified from 905,543 dogs in 2016; 72 laboratory-confirmed and 105 presumed. The 1-year period prevalence for hypoadrenocorticism in all dogs was 0.06% (95% confidence interval: 0.05-0.07%). The most common presenting clinical signs in laboratory-confirmed dogs were lethargy (51/66, 77.3%), anorexia (48/66, 66.7%) and vomiting (48/66, 66.7%). Hyperkalaemia was reported in 47 of 53 (88.7%), hyponatraemia in 46 of 53 (86.8%). Median sodium: potassium ratio was 19.00 (interquartile range: 16.20-20.60). Breed, age, neuter status and insurance status were associated with a laboratory-confirmed diagnosis of hypoadrenocorticism. No sex association with hypoadrenocorticism was observed in the multivariable model. The standard poodle had 51.38 times the odds (95% CI: 14.49-182.18) of hypoadrenocorticism compared with crossbreeds. The labradoodle and West Highland white terrier also had increased odds.

CLINICAL SIGNIFICANCE

This is the first epidemiological study to report on hypoadrenocorticism in dogs within the UK primary-care population. These results provide benchmark data of current veterinary activity relating to hypoadrenocorticism in primary-care practices.

摘要

目的

评估英国初级兽医护理下犬肾上腺皮质功能减退症的发病率、临床诊疗方法及风险因素。

材料与方法

通过检索匿名电子病历,从英国兽医指南针(VetCompass™)计划中识别出诊断为肾上腺皮质功能减退症的犬。纳入2016年之前已存在及新诊断的病例。根据电子病历记录的信息,病例进一步分为实验室确诊或疑似肾上腺皮质功能减退症两类。手动提取描述性数据。采用多变量逻辑回归方法识别人口统计学风险因素。

结果

2016年从905,543只犬中识别出177例肾上腺皮质功能减退症病例;72例实验室确诊,105例疑似。所有犬肾上腺皮质功能减退症的1年期患病率为0 . 06%(95%置信区间:0 . 05 - 0 . 07%)。实验室确诊犬最常见的临床表现为嗜睡(51/66,77.3%)、厌食(48/66,66.7%)和呕吐(48/66,66.7%)。53例中有47例(88.7%)报告有高钾血症,53例中有46例(86.8%)有低钠血症。钠钾比值中位数为19.00(四分位间距:16.20 - 20.60)。品种、年龄、去势状态和保险状态与实验室确诊的肾上腺皮质功能减退症相关。在多变量模型中未观察到性别与肾上腺皮质功能减退症有关联。与杂交犬相比,标准贵宾犬患肾上腺皮质功能减退症的几率高51.38倍(95%置信区间:14.49 - 182.18)。拉布拉多德利犬和西高地白梗患肾上腺皮质功能减退症的几率也增加。

临床意义

这是第一项关于英国初级护理犬群中肾上腺皮质功能减退症的流行病学研究。这些结果提供了当前初级护理实践中与肾上腺皮质功能减退症相关兽医活动的基准数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d62e/8248152/8fba6d8e0ae5/JSAP-62-343-g001.jpg

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