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標題: 慢性退行性房室瓣疾病患犬之都卜勒超音波腎臟 血流指數與以Enalapril治療後之變化
The Doppler Ultrasonographic Renal Hemodynamic Indices in Dogs with Chronic Degenerative Atrioventricular Valvular Disease and Changes after Treatment with Enalapril
作者: 吳欣怡
Wu, Hsin-Yi
關鍵字: 慢性退行性房室瓣疾病;Doppler Ultrasonographic;犬;超音波;腎臟血流指數;Renal Hemodynamic Indices;Dog;Chronic Degenerative Atrioventricular Valvular Disease;Enalapril
出版社: 獸醫學系暨研究所
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的犬隻,其腎臟血管阻力的改變,並監測患犬使用enalapril 治療後,對於腎臟血
量的治療。組別一使用enalapril 0.5 mg/kg,一天一次,連續使用四周,於一個月
後複診。組別二使用enalapril 0.5 mg/kg,一天兩次,連續使用四周,每周複診。
數則呈現極顯著的負相關性(p<0.01, 脈動指數:r2=0.381;阻抗指數:r2=0.410)。
一的腎臟血流指數在使用enalapril 治療一個月後,呈顯著上升。脈動指數與阻抗
指數分別從1.08±0.18 和0.63±0.04 上升到1.32±0.25 和0.69±0.05(p<0.05)。組別二
和0.69±0.05 上升到1.80±0.30 和0.79±0.04(p<0.05)。總結本研究,心臟病犬的腎臟
證明了enalapril 會促使慢性退行性房室瓣疾病患犬的腎臟血管阻力上升。因此,

Chronic degenerative atrioventricular valvular disease (CDAVD) is the most
common cause of heart failure in the dog. Angiotensin-converting-enzyme inhibitors
(ACEI), such as enalapril, have been found to be useful in the management and
alleviation of clinical signs related to heart failure in dogs. However, ACEI may depress
renal function in patients with severe congestive heart failure due to a further decrease
in renal perfusion. Doppler ultrasound is a non-invasive technique that can be used to
estimate vascular resistance by the calculation of pulsatility and resistive indices (PI and
RI). The indices have been found to be correlative with vascular changes in renal
diseases. The aims of this study were to examine renal vascular resistance changes in
dogs with CDAVD and to evaluate the influence of renal impedance after enalapril
treatment in these dogs. Twenty-six dogs with CDAVD and thirty-six healthy dogs were
included in this study. Physical examination, laboratory examination, thoracic
radiography, electrocardiogram, cardiac and renal ultrasound were performed on most
dogs. Twelve dogs with CDAVD were divided into two groups undergoing different
treatment protocol. Group 1 was prescribed enalapril (0.5 mg/kg, sid) for 4 weeks and
evaluated one month later. The other group was prescribed enalapril (0.5 mg/kg, bid) for
4 weeks and evaluated weekly. No correlation was found between the renal indices and
age, packed cell volume, blood urea nitrogen, creatinine, ejection fraction, or fractional
shortening in the subjects in our study. However, a significant negative correlation was
found between the indices and mean blood pressure in dogs with CDAVD (p<0.01, PI:
r2=0.381; RI: r2=0.405). The mean PI and RI values in dogs with CDAVD were higher
than that in normal animals but didn't reach significant levels. Nevertheless, there was a
significant effect attributable to the degree of heart failure. On the other hand, there was
a significant increase in the renal indices after administration of enalapril of group 1.
Mean PI and RI values significantly increased from 1.08±0.18 and 0.63±0.04 to
1.32±0.25 and 0.69±0.05 (p<0.05). In the group 2, the indices were also significantly
higher than before the treatment, too. The mean PI and RI values significantly increased
from 1.30±0.21 and 0.69±0.05 to 1.80±0.30 and 0.79±0.04 (p<0.05). It is concluded that
there are correlations between renal indices and blood pressure or left ventricular
diastolic function in dogs with CDAVD in the present study. Our results suggest a
positive correlation between renal vascular resistance and the severity of heart failure in
dogs. In this study, we demonstrated that enalapril promoted the increase of
renovascular resistance in dogs with CDAVD. Therefore, the PI and RI may provide
information to the veterinary clinicians when monitoring renal hemodynamic in dogs
with CDAVD undergoing treatment.
其他識別: U0005-1407200813422100
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