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英国犬血小板减少症的病因:762 例回顾性研究。

Causes of thrombocytopenia in dogs in the United Kingdom: A retrospective study of 762 cases.

机构信息

Animal Health Trust, Newmarket, Suffolk, UK.

Aúna Especialidades Veterinarias, IVC-Evidensia, Paterna, Valencia, Spain.

出版信息

Vet Med Sci. 2023 Jul;9(4):1495-1507. doi: 10.1002/vms3.1091. Epub 2023 May 22.

Abstract

BACKGROUND

Thrombocytopenia is a common laboratory abnormality in dogs, and numerous diseases have been associated with its development. Estimates for the sensitivity and specificity of the degree of reduction of platelet concentration for the diagnosis of primary immune-mediated thrombocytopenia (pITP) have not been reported.

OBJECTIVES

To report the prevalence of different causes of thrombocytopenia in dogs in the United Kingdom and to investigate the utility of platelet concentration to differentiate causes of thrombocytopenia.

METHODS

Medical records of 762 dogs with thrombocytopenia presented to seven referral hospitals from January 2017 to December 2018 were retrospectively reviewed. Cases were assigned into the following categories: pITP, infectious diseases, neoplasia, inflammatory/other immune-mediated disorders and miscellaneous causes. The prevalence of the different categories was estimated, and platelet concentrations were compared. Receiver-operating characteristic (ROC) curves were used to investigate the utility of platelet concentration to differentiate between causes of thrombocytopenia.

RESULTS

The most common disease category associated with thrombocytopenia was neoplasia (27.3%), followed by miscellaneous causes (26.9%), pITP (18.8%), inflammatory/immune-mediated disorders (14.4%) and infectious diseases (12.6%). Dogs with pITP had significantly lower platelet concentrations (median 8 × 10 /L, range: 0-70 × 10 /L) than dogs in the other four categories. Platelet concentration was useful for distinguishing pITP from other causes of thrombocytopenia (area under ROC curve = 0.89, 95% confidence interval 0.87, 0.92), with a platelet concentration ≤12 × 10 /L being 60% sensitive and 90% specific.

CONCLUSIONS

Severe thrombocytopenia was highly specific for a diagnosis of pITP, which was more prevalent in this UK population of thrombocytopenic dogs compared with previous epidemiological studies. Conversely, the proportion of dogs with infectious diseases was lower than in previous reports from other locations.

摘要

背景

血小板减少症是犬常见的实验室异常,许多疾病与之相关。目前尚未报道血小板浓度降低程度对原发性免疫介导性血小板减少症(pITP)诊断的敏感性和特异性的估计值。

目的

报告英国犬血小板减少症的不同病因患病率,并探讨血小板浓度对鉴别血小板减少症病因的作用。

方法

回顾性分析 2017 年 1 月至 2018 年 12 月期间,7 家转诊医院收治的 762 例血小板减少症犬的病历资料。将病例分为以下几类:pITP、传染病、肿瘤、炎症/其他免疫介导性疾病和其他原因。估计了不同类别疾病的患病率,并比较了血小板浓度。采用受试者工作特征(ROC)曲线分析血小板浓度鉴别血小板减少症病因的作用。

结果

最常见的与血小板减少症相关的疾病类别是肿瘤(27.3%),其次是其他原因(26.9%)、pITP(18.8%)、炎症/免疫介导性疾病(14.4%)和传染病(12.6%)。与其他 4 个类别相比,pITP 犬的血小板浓度明显更低(中位数 8×10 /L,范围:0-70×10 /L)。血小板浓度有助于鉴别 pITP 与其他原因引起的血小板减少症(ROC 曲线下面积=0.89,95%置信区间 0.87,0.92),血小板浓度≤12×10 /L 时,敏感性为 60%,特异性为 90%。

结论

严重血小板减少症高度提示为 pITP,与以往对英国血小板减少症犬的研究相比,pITP 更常见。而传染病的比例低于其他地区的报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d057/10357222/febc9af42f38/VMS3-9-1495-g003.jpg

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