Pearson E G, Dirksen G, Meyer J, Seitz A, Rowe K E
College of Veterinary Medicine, Oregon State University, Corvallis 97331, USA.
J Am Vet Med Assoc. 1995 Dec 1;207(11):1466-9.
To evaluate the efficacy of tests for hepatic disease in young calves.
Prospective case-control study.
28 clinically normal calves and 47 calves with histologically proven hepatic disease.
Liver function tests and serum activity of liver-derived enzymes were determined on 28 clinically normal calves at birth and at 2 weeks of age. These values were compared with the results from 47 calves with hepatic disease verified by histologic examination. Upper limit of confidence interval was determined for the results on the clinically normal calves, and Student's t-test was used to identify significant differences in the data from calves of various age-groups.
None of the results of the common tests for liver damage or function (measurement of bilirubin, gamma-glutamyltransferase, glutamate dehydrogenase [GMD], alkaline phosphatase, L-lactate dehydrogenase, aspartate transaminase, or alanine transaminase) were clinically useful when used alone for detection of hepatic disease in calves less than 6 weeks old. Sensitivity of gamma-glutamyltransferase, GMD, aspartate transaminase, and alkaline phosphatase as indicators of hepatic disease in this population of calves was 0, 59, 80, and 9%, respectively. Direct bilirubin (sensitivity, 87%) was more sensitive than total bilirubin (sensitivity, 66%). Serum enzyme activity of most enzymes (P < 0.01), total bilirubin concentration (P < 0.001), and sulfobromophthalein sodium clearance half-life were significantly higher (P < 0.001) in newborn calves than in 2-week-old calves.
Clinical findings that indicate hepatic disease in calves that are less than 6 weeks old could be confirmed by measurement of serum activity of GMD or concentrations of total serum bile acids or direct bilirubin. Percutaneous liver biopsy may still be needed and may provide the most information.
评估针对幼龄犊牛肝病检测的效果。
前瞻性病例对照研究。
28头临床健康犊牛和47头经组织学证实患有肝病的犊牛。
对28头临床健康犊牛在出生时和2周龄时进行肝功能检测及肝脏源性酶的血清活性测定。将这些值与47头经组织学检查证实患有肝病的犊牛的结果进行比较。确定临床健康犊牛检测结果的置信区间上限，并使用学生t检验来确定不同年龄组犊牛数据中的显著差异。
对于小于6周龄的犊牛，单独使用常见的肝损伤或肝功能检测（胆红素、γ-谷氨酰转移酶、谷氨酸脱氢酶[GMD]、碱性磷酸酶、L-乳酸脱氢酶、天冬氨酸转氨酶或丙氨酸转氨酶的测定）结果，在临床上均无助于肝病检测。在这群犊牛中，γ-谷氨酰转移酶、GMD、天冬氨酸转氨酶和碱性磷酸酶作为肝病指标的敏感性分别为0、59、80和9%。直接胆红素（敏感性87%）比总胆红素（敏感性66%）更敏感。大多数酶的血清酶活性（P<0.01）、总胆红素浓度（P<0.001）和磺溴酞钠清除半衰期在新生犊牛中显著高于2周龄犊牛（P<0.001）。
对于小于6周龄的犊牛，可通过测定GMD的血清活性或总血清胆汁酸或直接胆红素浓度来确诊提示肝病的临床症状。经皮肝活检可能仍有必要，且可能提供最多信息。
