基于 85 只犬的血浆白蛋白浓度和 8 个靶基因的血液学表达，预测肝外分流结扎或薄膜环扎的结果。

Prediction of outcome after ligation or thin film banding of extrahepatic shunts, based on plasma albumin concentration and hematologic expression of 8 target genes in 85 dogs.

机构信息

Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.

Royal GD, P.O. Box 9, 7400 AA Deventer, The Netherlands.

出版信息

J Vet Intern Med. 2023 Mar;37(2):537-549. doi: 10.1111/jvim.16680. Epub 2023 Mar 19.

DOI:10.1111/jvim.16680

PMID:36934445

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10061173/

Abstract

BACKGROUND

In dogs with a congenital extrahepatic portosystemic shunt (EHPSS), outcome after surgical attenuation is difficult to predict.

OBJECTIVES

Develop a minimally invasive test to predict outcome after surgical EHPSS attenuation and establish risk factors for postattenuation seizures (PAS).

ANIMALS

Eighty-five client-owned dogs referred for surgical attenuation of a single EHPSS.

METHODS

mRNA expression of 8 genes was measured in preoperatively collected venous blood samples. Outcome was determined at a median of 92 days (range, 26-208) postoperatively by evaluating clinical performance, blood test results and abdominal ultrasonography. Multivariable logistic regression was used to construct models predicting clinical and complete recovery. The associations between putative predictors and PAS were studied using univariable analyses.

RESULTS

Five of 85 dogs developed PAS. Risk factors were age, white blood cell (WBC) count and expression of hepatocyte growth factor activator and LysM and putative peptidoglycan-binding domain-containing protein 2. Clinical recovery was observed in 72 of 85 dogs and complete recovery in 51 of 80 dogs (median follow-up, 92 days). The model predicting clinical recovery included albumin, WBC count, and methionine adenosyltransferase 2 alpha (MAT2α) expression, whereas the model predicting complete recovery included albumin, and connective tissue growth factor precursor and MAT2α expression. The areas under the receiver operating characteristic curves were 0.886 (95% confidence interval [CI]: 0.783, 0.990) and 0.794 (95% CI: 0.686, 0.902), respectively.

CONCLUSIONS AND CLINICAL IMPORTANCE

Two models were constructed for predicting outcome after EHPSS attenuation using venous blood samples. The model predicting clinical recovery showed the best diagnostic properties. Clinical application requires further validation.

摘要

背景

在患有先天性肝外门体分流（EHPSS）的犬中，手术后的结果难以预测。

目的

开发一种微创测试来预测手术后 EHPSS 衰减的结果，并确定术后癫痫发作（PAS）的危险因素。

动物

85 只被转诊接受单一 EHPSS 手术衰减的患犬。

方法

在术前采集的静脉血样中测量了 8 个基因的 mRNA 表达。通过评估临床表现、血液检查结果和腹部超声检查，在手术后中位数为 92 天（范围，26-208 天）确定结果。使用多变量逻辑回归构建预测临床和完全恢复的模型。使用单变量分析研究潜在预测因子与 PAS 之间的关系。

结果

5 只 85 只犬发生 PAS。危险因素为年龄、白细胞（WBC）计数以及肝细胞生长因子激活物、LysM 和假定的肽聚糖结合域包含蛋白 2 的表达。85 只犬中有 72 只出现临床恢复，80 只犬中有 51 只出现完全恢复（中位数随访时间为 92 天）。预测临床恢复的模型包括白蛋白、WBC 计数和蛋氨酸腺苷转移酶 2α（MAT2α）表达，而预测完全恢复的模型包括白蛋白和结缔组织生长因子前体以及 MAT2α 表达。受试者工作特征曲线下面积分别为 0.886（95%置信区间[CI]：0.783，0.990）和 0.794（95% CI：0.686，0.902）。