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脾切除术在犬原发性免疫介导性溶血性贫血和原发性免疫介导性血小板减少症中的应用。

Splenectomy in the management of primary immune-mediated hemolytic anemia and primary immune-mediated thrombocytopenia in dogs.

机构信息

Animal Health Trust, Newmarket, Suffolk, United Kingdom.

Department of Veterinary Medicine, Univeristy of Cambridge, Cambridge, United Kingdom.

出版信息

J Vet Intern Med. 2022 Jul;36(4):1267-1280. doi: 10.1111/jvim.16469. Epub 2022 Jul 7.

Abstract

BACKGROUND

Current reports about the use of splenectomy for the management of immune-mediated hemolytic anemia (IMHA) or immune-mediated thrombocytopenia (ITP) or both in dogs are limited.

OBJECTIVES

To retrospectively describe the use of splenectomy as part of the management for IMHA, ITP, and concurrent IMHA and severe thrombocytopenia (CIST) in dogs. It was hypothesized that splenectomy would be beneficial in allowing for reduction of dose of immunosuppressive drugs or discontinuation in 1 or more of these groups.

ANIMALS

Seventeen client-owned dogs (7 with IMHA, 7 with ITP, and 3 with CIST) were identified across 7 UK-based referral hospitals from a study period of 2005 to 2016.

METHODS

Data were collected retrospectively via questionnaires and included information about diagnosis, management and treatment response before and after splenectomy. Based on clinical outcome, treatment with splenectomy as part of the management protocol was classified as either successful or unsuccessful.

RESULTS

Six of 7 dogs with ITP were managed successfully with splenectomy as part of their management protocol (3 complete and 3 partial responses), although 1 subsequently developed suspected IMHA. Of the 7 dogs with IMHA, splenectomy was part of a successful management protocol in 4 dogs (2 complete and 2 partial responses). In the CIST group, 1 case (1/3) responded completely to management with splenectomy as part of the management protocol.

CONCLUSIONS AND CLINICAL IMPORTANCE

Splenectomy was considered successful and well tolerated in most cases of isolated ITP. Whether there is a benefit of splenectomy in cases of IMHA and CIST could not be determined in the current study.

摘要

背景

目前关于脾切除术在治疗犬免疫介导性溶血性贫血(IMHA)或免疫介导性血小板减少症(ITP)或两者同时存在的报告有限。

目的

回顾性描述脾切除术作为治疗 IMHA、ITP 和并发 IMHA 和严重血小板减少症(CIST)的一部分的应用。假设脾切除术可使 1 种或多种药物的免疫抑制剂量减少或停药。

动物

在 2005 年至 2016 年期间,从英国 7 家转诊医院的研究中确定了 17 只患犬(7 只患有 IMHA、7 只患有 ITP 和 3 只患有 CIST)。

方法

通过问卷调查回顾性收集数据,包括脾切除术前后的诊断、管理和治疗反应信息。根据临床结果,将脾切除术作为治疗方案的一部分的治疗分为成功或不成功。

结果

在 7 只患有 ITP 的犬中,有 6 只(3 只完全缓解,3 只部分缓解)通过脾切除术成功管理,尽管其中 1 只随后出现疑似 IMHA。在 7 只患有 IMHA 的犬中,脾切除术是成功管理方案的一部分,有 4 只(2 只完全缓解,2 只部分缓解)。在 CIST 组中,1 只(3 只中的 1 只)完全缓解,脾切除术作为管理方案的一部分。

结论和临床意义

在大多数孤立性 ITP 病例中,脾切除术被认为是成功且耐受良好的。在目前的研究中,无法确定脾切除术在 IMHA 和 CIST 病例中的益处。

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