Departamento de Clínica e Cirurgia Veterinárias, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Veterinary Medical Teaching Hospital and Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.
Vet Clin Pathol. 2021 Sep;50(3):384-393. doi: 10.1111/vcp.12987. Epub 2021 Aug 1.
There is disagreement in the literature about the proportion of neutrophils expected in canine transudates. A cutoff of <30% neutrophils has been recommended for distinguishing transudates from exudates, but its validity has not been established.
The aim of this study was to evaluate differential cell counts in canine effusions and analyze the percentage and number of neutrophils in transudates and exudates.
Effusion data were obtained retrospectively from 263 dogs with pleural or peritoneal effusion. Low-protein transudates, high-protein transudates, and exudates were classified using the total protein (TP) concentration and total nucleated cell count (TNCC). Differential percentages and absolute neutrophil counts were compared by the effusion type and underlying etiology.
Low-protein transudates (n = 63), high-protein transudates (n = 84), and exudates (n = 77) had a median (range) of 35% (0%-100%), 59% (0%-100%), and 90% (50%-98%) neutrophils (P < .0001). All effusions with <50% neutrophils were transudates, but 53% of transudates had ≥50% neutrophils, and 69% had ≥30%. Median neutrophil counts were 62/µL (0-892/µL), 538/µL (0-4550/µL), and 45 590/µL (5400-496 800/µL) in low-protein transudates, high-protein transudates, and exudates, respectively (P < .0001). Neutrophil counts correlated with TNCC (r = 0.99), such that using neutrophil cutoffs did not affect effusion classifications in most cases. Neutrophil percentages and counts were higher in effusions from dogs with uroabdomen and sepsis (P < .01); neutrophil counts were lower in dogs with hepatic insufficiency (P < .0001). Uroabdomen usually caused low-protein, high-neutrophil exudates.
Although effusions with <50% neutrophils are transudates, most transudates and exudates have ≥50% neutrophils, limiting the diagnostic usefulness of % neutrophils for classifying effusions. Absolute neutrophil cutoffs did not notably improve effusion classification but could warrant future studies.
文献中对于犬渗出液中中性粒细胞的预期比例存在分歧。有人建议将 <30%的中性粒细胞作为区分渗出液和漏出液的截断值，但尚未确定其有效性。
本研究旨在评估犬渗出液中的细胞分类，并分析渗出液和漏出液中的中性粒细胞百分比和数量。
回顾性收集 263 例患有胸腔或腹腔渗出液的犬的渗出液数据。根据总蛋白 (TP) 浓度和总核细胞计数 (TNCC) 将低蛋白渗出液、高蛋白渗出液和渗出液分类。根据渗出液类型和潜在病因比较不同百分比和绝对中性粒细胞计数。
低蛋白渗出液 (n=63)、高蛋白渗出液 (n=84) 和渗出液 (n=77) 的中位数 (范围) 分别为 35% (0%-100%)、59% (0%-100%) 和 90% (50%-98%) 的中性粒细胞 (P<.0001)。所有 <50%中性粒细胞的渗出液均为漏出液，但 53%的漏出液中有≥50%的中性粒细胞，69%的漏出液中有≥30%的中性粒细胞。低蛋白渗出液、高蛋白渗出液和渗出液的中位中性粒细胞计数分别为 62/µL (0-892/µL)、538/µL (0-4550/µL) 和 45590/µL (5400-496800/µL) (P<.0001)。中性粒细胞计数与 TNCC 呈正相关 (r=0.99)，因此在大多数情况下，使用中性粒细胞截断值不会影响渗出液分类。患有尿腹和脓毒症的犬渗出液中的中性粒细胞百分比和计数较高 (P<.01)；患有肝衰竭的犬中性粒细胞计数较低 (P<.0001)。尿腹通常导致低蛋白、高中性粒细胞渗出液。
虽然 <50%中性粒细胞的渗出液为漏出液，但大多数渗出液和漏出液的中性粒细胞≥50%，限制了 %中性粒细胞用于分类渗出液的诊断价值。绝对中性粒细胞截断值并未显著改善渗出液分类，但可能值得进一步研究。
