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慢性给予超生理剂量糖皮质激素后患病犬的血清胰腺脂肪酶免疫活性。

Serum pancreatic lipase immunoreactivity in sick dogs after chronic administration of supraphysiologic doses of glucocorticoids.

机构信息

Veterinary Specialty Hospital of San Diego, San Diego, CA, USA.

Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.

出版信息

Vet Clin Pathol. 2022 Feb;50 Suppl 1:63-69. doi: 10.1111/vcp.12943. Epub 2021 Jul 19.

Abstract

BACKGROUND

Glucocorticoids (GC) are commonly used for a long term to treat a multitude of immune-mediated, inflammatory, and neoplastic diseases in dogs. Conflicting results of published studies on the effects of exogenous and endogenous GCs on serum canine pancreatic lipase immunoreactivity (cPLI) raise the question of whether cPLI concentrations can be reliably interpreted in patients receiving GCs.

OBJECTIVE

We sought to determine the effect of long-term GC administration at supraphysiologic doses on serum cPLI concentrations in sick dogs.

METHODS

Serum samples were collected from 35 client-owned dogs. Dogs were administered prednisone at a dose of ≥0.5 mg/kg per day for ≥3 weeks. Serum cPLI was measured prior to the initiation and after ≥3 weeks of GC therapy.

RESULTS

There was a significant increase in serum cPLI between baseline (median 101 μg/L; range 30-1997 μg/L) and following the administration of ≥0.5 mg/kg/day of prednisone (median 173 μg/L; range 30-2000 μg/L) in dogs (P = 0.025). However, the median change was small (31 μg/L). There was no suspicion of pancreatitis in any of the dogs. Diagnostic interpretation changed in 6/35 dogs, with no apparent dose-response relationship.

CONCLUSIONS

There was a statistically significant difference from baseline in serum cPLI measurements in sick dogs receiving long-term prednisone. Although the change was small and often clinically insignificant, it could pose a clinical interpretation dilemma in some dogs. It is unknown whether these observations are coincidental due to subclinical pancreatitis or caused by another effect of GCs on pancreatic acinar cells.

摘要

背景

糖皮质激素(GC)常用于长期治疗犬的多种免疫介导、炎症和肿瘤疾病。已发表的关于外源性和内源性 GC 对血清犬胰腺脂肪酶免疫反应性(cPLI)影响的研究结果相互矛盾,这使得人们质疑在接受 GC 治疗的患者中,cPLI 浓度是否可以可靠地解释。

目的

我们旨在确定长期给予超生理剂量 GC 对患病犬血清 cPLI 浓度的影响。

方法

收集了 35 只患犬的血清样本。犬给予泼尼松龙的剂量为≥0.5mg/kg/天,持续≥3 周。在开始治疗前和 GC 治疗≥3 周后测量血清 cPLI。

结果

与基线相比(中位数 101μg/L;范围 30-1997μg/L),接受≥0.5mg/kg/天泼尼松龙治疗后犬的血清 cPLI 显著升高(中位数 173μg/L;范围 30-2000μg/L)(P=0.025)。然而,中位数变化较小(31μg/L)。在任何犬中均未怀疑患有胰腺炎。在 6/35 只犬中,诊断解释发生了变化,但无明显的剂量反应关系。

结论

接受长期泼尼松龙治疗的患病犬的血清 cPLI 测量值与基线相比有统计学显著差异。尽管变化较小,且通常无临床意义,但在某些犬中可能会造成临床解释的困境。尚不清楚这些观察结果是由于亚临床胰腺炎还是 GC 对胰腺腺泡细胞的其他影响所致。

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