77例犬急性肾损伤的临床病例调查分析

Investigation and analysis of 77 clinical cases of canine acute kidney injury

为了了解当前犬急性肾损伤发病和诊疗情况,回顾性调查分析2019年1—12月份江苏南部地区15家宠物医院诊治的77例犬急性肾损伤病例,分析病例的发病年龄、性别、发病时间、临床症状、病因、血常规、血液生化指标、血气及电解质、尿液、影像学、肾脏损伤分级和治疗结果等。结果表明:大多数患犬年龄为2~10岁,雄性犬发病率较高,10—12月份为高发时间;在进入无尿期之前,该病无特有临床症状;该病发病原因复杂,多数病例病因不明,常并发其他疾病;仅37.33%的患犬有贫血症状;患犬大多表现为肌酐和尿素氮含量升高,且初诊病例肾脏损伤Ⅲ级以上的中度至重度病例较多;66.67%患犬血液pH值下降,表现酸血症;进行尿液分析的病例和进行腹部B型超声波检查的病例占比不高;病例以传统输液治疗为主,总体治愈率为50.65%,且该病分级和并发症对治愈率影响较大。说明该地区犬急性肾损伤诊断主要依靠血液生化指标检查,诊断具有一定的滞后性,且治疗手段以传统输液疗法为主,总体治愈率不高,因此一定要做到早发现、早治疗。

In order to understand the current incidence, diagnosis and treatment of canine acute kidney injury, a retrospective investigation and analysis of 77 canine acute kidney injury cases diagnosed and treated in 15 pet hospitals in southern area of Jiangsu Province from January to December 2019, those were analyzed including dog’s age of onset, gender, time of onset, clinical symptoms, etiology, blood routine, blood biochemical indicators, blood gas and electrolytes, urine, imaging, kidney injury classification and treatment results. The results showed that most of the affected dogs were 2 to 10 years old, and the incidence of male dogs was relatively high;October to December was the time of high incidence. Before entering the anuric period, the disease had no specific clinical symptoms;the cause of the disease was complicated, and the cause of most cases was unknown, often complicated by other diseases. Only 37.33% of the affected dogs had anemia symptoms;most of the affected dogs showed elevated creatinine and urea nitrogen content, and there were more cases of moderate to severe kidney damage above grade Ⅲ in newly diagnosed cases. The blood pH value of 66.67% of the affected dogs decreased and showed acidemia. The proportions of cases undergoing urinalysis and cases undergoing abdominal B-mode ultrasound scan were not high. The cases were mainly treated by traditional infusion, and the overall cure rate was 50.65%;and the grade of the disease and complications had a greater impact on the cure rate. The results suggested that the diagnosis of canine acute kidney injury in this area mainly relied on blood biochemical indexes examination, and the diagnosis had a certain lag;and the treatment methods were mainly traditional infusion therapy, the overall cure rate was not high, therefore, should achieve early detection and early treatment.