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犬肾上腺皮质功能减退症的临床特征、治疗及预后

Clinical characteristics, treatment, and outcomes of hypoadrenocorticism in dogs.

作者信息

Sherrod T N, Lashnits E, Lunn K F

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.

出版信息

J Small Anim Pract. 2025 Sep;66(9):627-635. doi: 10.1111/jsap.13870. Epub 2025 Apr 16.

Abstract

OBJECTIVES

To determine the long-term survival of dogs with hypoadrenocorticism during the period that desoxycorticosterone pivalate has become widely used. Secondary goals were to compare age at diagnosis, median survival times, and age at death for dogs with hyponatraemic and/or hyperkalaemic hypoadrenocorticism and eunatraemic eukalaemic hypoadrenocorticism, and to determine the frequency of glucocorticoid-related side effects in these dogs.

MATERIALS AND METHODS

Retrospective cohort study with data collected from medical records and from a questionnaire sent to owners of affected dogs.

RESULTS

141 cases were identified; 125 had spontaneous hypoadrenocorticism and 16 had iatrogenic hypoadrenocorticism secondary to treatment of hyperadrenocorticism. Dogs with spontaneous hyponatraemic and/or hyperkalaemic hypoadrenocorticism were significantly younger at the time of diagnosis (median age: 5.1, range: 0.8 to 14.1 years, n = 97) compared to dogs with spontaneous eunatraemic eukalaemic hypoadrenocorticism (median age: 8.3, range: 3.0 to 12.7 years, n = 26). Sixty-six dogs were included in the survival analysis. For dogs with spontaneous hyponatraemic and/or hyperkalaemic hypoadrenocorticism, all of which were managed with desoxycorticosterone pivalate, median survival time was 5.7 years (95% CI: 4.0 to 7.2 years; n = 47) and median age at death was 11.0 years (range: 4.0 to 17.0 years; n = 30). For dogs with spontaneous eunatraemic eukalaemic hypoadrenocorticism, median survival time was 5.6 years (95% CI: 4.1-N/A years; n = 9) and median age at death was 11.8 years (range: 11.0 to 13.0 years; n = 4). The majority of owners that completed the questionnaire reported side effects commonly associated with glucocorticoid therapy.

CLINICAL SIGNIFICANCE

Hypoadrenocorticism carries an excellent prognosis. Desoxycorticosterone pivalate was the most frequently used mineralocorticoid therapy in this group of dogs.

摘要

目的

确定在去氧皮质酮新戊酸酯广泛使用期间患有肾上腺皮质功能减退症犬的长期存活率。次要目标是比较患有低钠血症和/或高钾血症性肾上腺皮质功能减退症的犬与血钠正常血钾正常性肾上腺皮质功能减退症的犬在诊断时的年龄、中位生存时间和死亡年龄,并确定这些犬中糖皮质激素相关副作用的发生率。

材料与方法

采用回顾性队列研究,数据收集自病历以及向患病犬主人发送的问卷。

结果

共识别出141例病例;125例为自发性肾上腺皮质功能减退症,16例为继发于肾上腺皮质功能亢进症治疗后的医源性肾上腺皮质功能减退症。与血钠正常血钾正常性肾上腺皮质功能减退症的犬(中位年龄:8.3岁,范围:3.0至12.7岁,n = 26)相比,患有自发性低钠血症和/或高钾血症性肾上腺皮质功能减退症的犬在诊断时明显更年轻(中位年龄:5.1岁,范围:0.8至14.1岁,n = 97)。66只犬纳入生存分析。对于患有自发性低钠血症和/或高钾血症性肾上腺皮质功能减退症且均采用去氧皮质酮新戊酸酯治疗的犬,中位生存时间为5.7年(95%可信区间:4.0至7.2年;n = 47),中位死亡年龄为11.0岁(范围:4.0至17.0岁;n = 30)。对于患有自发性血钠正常血钾正常性肾上腺皮质功能减退症的犬,中位生存时间为5.6年(95%可信区间:4.1 - 无可用数据年;n = 9),中位死亡年龄为11.8岁(范围:11.0至13.0岁;n = 4)。大多数完成问卷的主人报告了通常与糖皮质激素治疗相关的副作用。

临床意义

肾上腺皮质功能减退症预后良好。去氧皮质酮新戊酸酯是该组犬中最常用的盐皮质激素疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c717/12417096/1ec47c72cacf/JSAP-66-627-g002.jpg

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