呼吸功能檢查於貓支氣管病臨床診斷之研究

Abstract

氣喘在人類是一種慢性的呼吸道疾病，是由許多原因相互影響所造成的，其中包括呼吸氣流阻塞、支氣管反應亢進及炎症反應。在貓也發現到類似氣喘的問題，且被命名為貓氣喘、過敏性支氣管炎以及貓支氣管病。貓支氣管病需要進行許多檢查將其他普遍的呼吸道疾病排除加以診斷。現今，在貓可使用非侵入性的肺功能測試檢查呼吸道力學進一步確定呼吸道的反應性。並且在氣喘病患進行皮內過敏原測試可瞭解某些特定的過敏原會引起免疫球蛋白(IgE)的反應。此論文包含兩個部份的研究，第一個研究評估使用全身大氣氣流計及支氣管刺激測試來診斷貓支氣管病，第二個研究則使用皮內過敏原測試確定特定過敏原在貓氣管病貓隻的盛行率。第一個研究結果顯示引起健康貓隻(0.358 ± 0.190%)支氣管收縮的副交感興奮劑(Carbachol)濃度較罹患貓氣管病貓隻高(0.061 ± 0.039%, P < 0.0001)，表示罹患貓支氣管病貓隻的呼吸道反應性較正常貓高，且呼吸道反應性與疾病嚴重性有相關性(r = -0.43; P = 0.0395)。重複進行支氣管刺激測試的結果也十分穩定(r = 0.63, P = 0.027)。第二個研究結果顯示居家灰塵為主要造成貓支氣管的過敏原，但和塵蹣沒有關係。對於家塵的過敏反應程度也與疾病嚴重性有相關性(r = 0.61; P = 0.0074)。

Asthma is a chronic disorder of the airways in humans that involves a complex interaction of airflow obstruction, bronchial hyper responsiveness and underlying inflammation. Asthma has been recognized in cats and has been termed feline asthma, allergic bronchitis, feline bronchitis and feline bronchial disease (FBD). Diagnosis of FBD was base on exclude other common causes of airway inflammation by several examinations. Non-invasive pulmonary function tests have been developed to examine airway mechanics in cats to determine airway responsiveness (AR). The target of specific immunoglobulin E (IgE) antibodies to offending allergens can be identified using intradermal skin tests (IDST) was also described in asthmatic patients. This thesis included two studies, firstly to evaluate the use of barometric whole-body plethysmography (BWBP) and bronchoprovocation in the diagnosis of FBD, and secondly to determine the prevalence of positive IDST reactions in cats with FBD. Results of first study revealed that bronchocontrictive agent (carbachol) concentration inducing bronchoconstrction was significantly higher in clinically healthy cats (0.358 ± 0.190%) compared to cats with bronchial disease (0.061 ± 0.039%, P < 0.0001), and AR was correlated with disease severity in cats with bronchial disease (r = -0.43; P = 0.0395). These results were reproducible and correlated positively (r = 0.63, P = 0.027) in two separate test occasions. Results of the second study revealed that house dust was the major allergen associated with feline bronchial disease (P = 0.0359). Allergen reactions to house dust significantly correlated with the clinical presentation and history of bronchial disease (r = 0.61; P = 0.0074).