26例犬免疫介导性血小板减少症回顾性分析

旨在调查犬免疫介导性血小板减少症(immune thrombocytopenia，ITP)的发病和治疗情况，并探讨预后相关因素。本研究自2018―2019年于中国农业大学动物医院接诊的病例中筛选出26例符合要求的ITP病例，记录患犬的基本信息、临床表现、实验室检查结果以及治疗和预后情况，并进行统计学分析。结果显示，贵宾犬为主要的发病品种(58%)；伊文氏综合征(Evans syndrome)与诊断后短期内(14 d)死亡显著相关(P=0.02)；初诊时，所有患犬皆具有出血的临床表现，根据一种新型犬ITP出血评估工具(DOGiBAT)所得出的评分范围为3~10分，其中,评分>5的患犬与诊断后短期内死亡显著相关(P=0.03)，提示出血评分对判断疾病转归有一定的指导意义。此外，出血评分>5的犬C反应蛋白(C-reactive protein, CRP)检测结果显著高于出血评分≤5的犬(P=0.01)，初步提示CRP具有辅助判断ITP严重程度的意义。本研究建议在评估ITP预后时引入出血评分工具，相比单一的临床表现更能量化疾病的严重程度，并提供可靠的预后判断。

Retrospective Analysis of 26 Dogs with Immune Thrombocytopenia

The aim of this study was to investigate the incidence and treatment of canine immune thrombocytopenia (ITP), and to explore the prognostic factors. In this retrospective cohort study, 26 eligible ITP cases were collected from the Veterinary Teaching Hospital of China Agricultural University from 2018 to 2019, and the basic information, clinical manifestations, laboratory test results, treatment and prognosis of the affected dogs were recorded and analyzed. Among the medical records, the poodle account for the highest proportion (58%). Evans syndrome was significantly correlated with death in the short term (14 days) after diagnosis (P=0.02). When first admitted to the hospital, all dogs had clinical signs of bleeding. According to a new dog bleeding assessment tool (DOGiBAT), the scores of the patients in this study ranged from 3 to 10, and dogs with a score >5 were associated with death within a short period after diagnosis (P=0.03), suggesting that the bleeding score could be an indicator for the prognosis of the disease. Besides, the CRP levels in the bleeding score >5 group are higher than that in the bleeding score ≤ 5 group (P=0.01), which suggests that CRP could be used to determine the severity of ITP. This study suggests the introduction of a bleeding score tool in assessing the prognosis of ITP. Compared with a single clinical sign, the bleeding scoring tool could assess the severity of ITP with a reliable metric system.