貓多囊性腎病之臨床研究

Clinical Evaluation of Feline Polycystic Kidney Disease

吳采蓉(Tsai-Jung Wu)

指導教授 ： 黃慧璧

國立臺灣大學/獸醫專業學院/臨床動物醫學研究所/碩士(2010年)

https://doi.org/10.6342/NTU.2010.00388

摘要

多囊性腎病在人類是常見的遺傳性疾病之一，多數為體顯性遺傳。患者在腎臟會出現為數不等的囊狀空泡，並隨年齡增大，進而壓迫正常腎臟組織而影響腎功能，最終造成腎臟衰竭。在貓也可發現此種體顯性遺傳的多囊性腎病，主要好發於波斯及波斯混種的貓隻，偶爾可也在其他貓種發現。貓的多囊性腎病與人類的多囊性腎病不論在形態學或發生學上都非常相似，也有類似的臨床表現，並在疾病末期造成腎臟衰竭。多囊性腎病的診斷主要依據為腎臟超音波檢查，而近年來在致病基因的研究中亦發現一個位於PKD1基因位置的突變，因此也可利用分子生物學的方式針對PKD1基因異常做檢測。此論文包含兩個部份的研究，第一個研究為評估多囊性腎病在台灣貓隻的盛行率，並比較不同診斷方式的結果；第二個研究為評估血壓與貓隻是否罹患多囊性腎病及其血清肌酐酸濃度間之關聯。第一個研究結果顯示在波斯貓族群中，多囊性腎病之盛行率為23.3%，相較其他研究報告為低；而在整體貓族群中，多囊性腎病之盛行率為12.0%。而比較超音波檢查與異常PKD1基因的結果，顯示在波斯貓中此二種檢查具有高度的一致性(κ=0.84)，但在其他貓種則為極低程度的一致性(κ=0)。此結果表示異常基因之檢查僅適用於波斯及其相關貓種，但整體而言，腎臟超音波仍為較適合的診斷工具。第二個研究結果顯示，雖然高血壓在人類為多囊性腎病常見的併發症，但貓的多囊性腎病與血壓之間並無關聯。在本研究中，會顯著影響血壓的因子只有年齡 (P=0.01)，而較年老的貓通常具有較高的血壓。

關鍵字

貓 ； 多囊性腎病 ； 盛行率 ； 超音波 ； 聚合酶鏈鎖反應 ； 血壓

並列摘要

Polycystic kidney disease (PKD) is one of the most common inherited diseases in human, which is mostly autosomal dominant inherited and characterized by numbers of cysts occurred in renal parenchyma and results in end stage renal disease. In cats, the autosomal dominant PKD (ADPKD) is common in Persian cats and its out-crossed breeds, and could also be found in others breeds occasionally. Feline ADPKD shares many morphologic and pathogenetic features with ADPKD in human patients, and often results in renal failure at the end of disease. Diagnosis of PKD has primarily relied on renal ultrasonography, and a newly developed molecular method has been used to detect the mutated gene, PKD1 .This thesis includes two studies, the prevalence of polycystic kidney disease in cats in Taipei city and comparison of ultrasonographic findings and PCR result, and evaluation of systolic blood pressure and serum creatinine concentration in cats with and without polycystic kidney disease. Results of the first study revealed the prevalence of 23.3% in PKD in Persian and Persian related breeds and 12.0% in overall cats. The agreement between ultrasonography and PCR results was almost perfect (κ=0.84) in Persian and Persian related cats but slight in other breeds (κ=0), indicating PCR might only available in Persians, and ultrasonography might be a preferable method for diagnosis of PKD. Results of the second study revealed no significant correlation between PKD and systolic blood pressure or hypertension, although hypertension is a common complication in human patients with PKD. Furthermore, age (P=0.01) was the only factor affecting blood pressure in this study, and older cats tended to have higher blood pressure.

並列關鍵字

Feline ； polycystic kidney disease ； ultrasonography ； PCR ； blood pressure

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