Lippi Ilaria, Puccinelli Caterina, Perondi Francesca, Ceccherini Gianila, Pierini Alessio, Marchetti Veronica, Citi Simonetta
Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, San Piero a Grado, 56122 Pisa, Italy.
Ospedale Veterinario San Concordio, Via Savonarola 106/f, 55100 Lucca, Italy.
Vet Sci. 2021 Feb 8;8(2):25. doi: 10.3390/vetsci8020025.
A retrospective case control study, which aimed to evaluate potential clinical, laboratory and imaging predictors of fatal pulmonary haemorrhage in dogs with Leptospirosis submitted to haemodialysis. The study population was divided in two groups according to the presence (PH) or absence (nPH) of pulmonary haemorrhage. A statistical comparison was performed at hospital admission for clinical (spontaneous bleeding, icterus, and respiratory distress), laboratory (serum creatinine, urea, phosphate, calcium, bicarbonate, bilirubin, AST, ALT, ALKP, GGT, total protein, albumin, glycaemia, sodium, potassium, CRP, RBC, HCT, HGB, WBC, PLT, PT, aPTT, fibrinogen), and pulmonary radiographic findings between the two groups of dogs. At hospital admission, dogs developing pulmonary haemorrhage were more likely to have respiratory distress ( = 0.002), severely elevated serum bilirubin ( = 0.002), AST ( = 0.04), ALT ( = 0.012), ALKP ( = 0.002), reduced serum glycaemia ( = 0.014), and thrombocytopenia ( = 0.04). Respiratory distress and elevated serum bilirubin (≥11.5 mg/dL) were independently associated with increased risk of pulmonary haemorrhage. In conclusion, the presence of respiratory distress at hospital admission is strongly associated (OR 40.9) with increased risk of pulmonary haemorrhage, even though no abnormalities are found at chest radiography.
一项回顾性病例对照研究，旨在评估接受血液透析的钩端螺旋体病犬致命性肺出血的潜在临床、实验室和影像学预测指标。根据是否存在肺出血，将研究人群分为两组，即肺出血组（PH）和无肺出血组（nPH）。对两组犬在入院时的临床指标（自发性出血、黄疸和呼吸窘迫）、实验室指标（血清肌酐、尿素、磷酸盐、钙、碳酸氢盐、胆红素、谷草转氨酶、谷丙转氨酶、碱性磷酸酶、γ-谷氨酰转肽酶、总蛋白、白蛋白、血糖、钠、钾、C反应蛋白、红细胞、血细胞比容、血红蛋白、白细胞、血小板、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原）和肺部影像学检查结果进行了统计学比较。入院时，发生肺出血的犬更易出现呼吸窘迫（P = 0.002）、血清胆红素严重升高（P = 0.002）、谷草转氨酶（P = 0.04）、谷丙转氨酶（P = 0.012）、碱性磷酸酶（P = 0.002）、血清血糖降低（P = 0.014）和血小板减少（P = 0.04）。呼吸窘迫和血清胆红素升高（≥11.5 mg/dL）与肺出血风险增加独立相关。总之，入院时存在呼吸窘迫与肺出血风险增加密切相关（比值比40.9），即使胸部X线检查未发现异常。
