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比较超声、胸部 X 线、C 反应蛋白和临床检查在治疗吸入性肺炎的犬中的应用。

Comparison of lung ultrasound, chest radiographs, C-reactive protein, and clinical findings in dogs treated for aspiration pneumonia.

机构信息

Department of Clinical Sciences, University of Liège, Faculty of Veterinary Medicine, Liège, Belgium.

Department of Veterinary Clinical and Diagnostic Sciences, University of Calgary, Calgary, Canada.

出版信息

J Vet Intern Med. 2022 Mar;36(2):743-752. doi: 10.1111/jvim.16379. Epub 2022 Mar 5.

DOI:10.1111/jvim.16379
PMID:35247005
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8965265/
Abstract

BACKGROUND

Comparison of clinical findings, chest radiographs (CXR), lung ultrasound (LUS) findings, and C-reactive protein (CRP) concentrations at admission and serial follow-up in dogs with aspiration pneumonia (AP) is lacking.

HYPOTHESIS

Lung ultrasound lesions in dogs with AP are similar to those described in humans with community-acquired pneumonia (comAP); the severity of CXR and LUS lesions are similar; normalization of CRP concentration precedes resolution of imaging abnormalities and more closely reflects the clinical improvement of dogs.

ANIMALS

Seventeen dogs with AP.

METHODS

Prospective observational study. Clinical examination, CXR, LUS, and CRP measurements performed at admission (n = 17), 2 weeks (n = 13), and 1 month after diagnosis (n = 6). All dogs received antimicrobial therapy. Lung ultrasound and CXR canine aspiration scoring systems used to compare abnormalities.

RESULTS

B-lines and shred signs with or without bronchograms were identified on LUS in 14 of 17 and 16 of 17, at admission. Chest radiographs and LUS scores differed significantly using both canine AP scoring systems at each time point (18 regions per dog, P < .001). Clinical and CRP normalization occurred in all dogs during follow up. Shred signs disappeared on LUS in all but 1 of 6 dogs at 1 month follow-up, while B-lines and CXR abnormalities persisted in 4 of 6 and all dogs, respectively.

CONCLUSION AND CLINICAL IMPORTANCE

Lung ultrasound findings resemble those of humans with comAP and differ from CXR findings. Shred signs and high CRP concentrations better reflect clinical findings during serial evaluation of dogs.

摘要

背景

患有吸入性肺炎(AP)的犬在入院时和连续随访期间的临床检查、胸部 X 光(CXR)、肺部超声(LUS)结果和 C 反应蛋白(CRP)浓度的比较研究较少。

假设

AP 犬的肺部超声病变与社区获得性肺炎(comAP)人类描述的病变相似;CXR 和 LUS 病变的严重程度相似;CRP 浓度的正常化先于影像学异常的消退,更能反映犬临床改善情况。

动物

17 只患有 AP 的犬。

方法

前瞻性观察研究。在入院时(n=17)、2 周时(n=13)和诊断后 1 个月时(n=6)进行临床检查、CXR、LUS 和 CRP 测量。所有犬均接受了抗菌治疗。使用肺部超声和 CXR 犬吸入评分系统来比较异常。

结果

在 17 只犬中,14 只在入院时和 16 只在入院时可在 LUS 上检测到 B 线和碎片征,伴有或不伴有支气管影。在每个时间点,两种犬吸入性肺炎评分系统均显示 CXR 和 LUS 评分存在显著差异(每只犬 18 个区域,P<.001)。在整个随访期间,所有犬的临床症状和 CRP 均恢复正常。在 1 个月随访时,除 1 只犬外,所有犬的 LUS 上的碎片征均消失,但在 4 只犬和所有犬中仍存在 B 线和 CXR 异常。

结论和临床意义

肺部超声表现与人类 comAP 相似,与 CXR 表现不同。碎片征和高 CRP 浓度在犬的连续评估中能更好地反映临床发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/1438a6a32a27/JVIM-36-743-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/88944e5f8bac/JVIM-36-743-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/ed6f697ee0e4/JVIM-36-743-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/5a035e596c56/JVIM-36-743-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/621a89c1e230/JVIM-36-743-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/ced97188dd77/JVIM-36-743-g014.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/1504c709267f/JVIM-36-743-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/1438a6a32a27/JVIM-36-743-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/88944e5f8bac/JVIM-36-743-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/ed6f697ee0e4/JVIM-36-743-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/5a035e596c56/JVIM-36-743-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/621a89c1e230/JVIM-36-743-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/ced97188dd77/JVIM-36-743-g014.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/1504c709267f/JVIM-36-743-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dda/8965265/1438a6a32a27/JVIM-36-743-g008.jpg

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