A comprehensive analysis of 174 febrile patients admitted to Okayama University Hospital.
A comprehensive analysis of 174 febrile patients admitted to Okayama University Hospital.
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冈山大学医院收治的174例发热患者的综合分析。
DOI：
10.18926/amo/51067
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发表时间：
2013
影响因子：
0.5
通讯作者：
F. Otsuka
中科院分区：
文献类型：
--
作者：
Hiromasa Ryuko;F. Otsuka
初级保健医生经常遇到不明原因且没有明显原因的发烧患者。实验室医学的最新进展促进了诊断程序；然而，在早期阶段确定关键的发热因素仍然很困难。我们回顾了2004年至2010年期间以发热（>37.5℃）为主诉的174例患者的病历，将患者分为感染、炎症、肿瘤和药物性发热患者。通过分类分析发现，患者的年龄、体温、发热持续时间与最终诊断密切相关。非细菌感染组血清CRP水平显着较低，而肿瘤和药物诱发病例血清sIL-2R水平较高。入院时CRP水平与体温呈弱但显着相关，而发热持续时间与体温呈负相关。 PET-CT 和组织活检的诊断有效性相当高，尤其是在肿瘤和非特异性炎症类别中，但细菌培养的有效性较低。因此，仔细检查身体和实验室信息，包括体温、CRP水平、发烧持续时间、性别差异和用药史对于诊断是必不可少的。通过全面、系统的检查进行逐步分类和疾病分类，对于确定发热原因非常有帮助。
Primary care physicians often encounter patients with fever of unknown origin and without apparent causes. Recent advances in laboratory medicine have facilitated diagnostic procedures;however, it is still difficult to determine the critical febrile factor at an early stage. We reviewed the medical records of 174 patients who were admitted due to a chief complaint of fever (>37.5℃) to our hospital during the period from 2004 to 2010. The patients were categorized into patients with infection, inflammation, neoplasm and drug-induced fever. Based on the analysis done by category, it was revealed that the patient's age, body temperature and duration of fever were closely related to the final diagnosis. Serum CRP levels were significantly low in the nonbacterial infection group, while serum levels of sIL-2R were high in neoplasm and drug-induced cases. CRP level on admission was weakly but significantly correlated with body temperature, while duration of fever was inversely related to body temperature. The effectiveness of PET-CT and tissue biopsy for diagnosis was considerably high, particularly in the categories of neoplasm and nonspecific inflammation, respectively, though the effectiveness of bacterial culture was low. Thus, a careful review of physical and laboratory information including body temperature, CRP level, duration of fever, gender difference and history of medication is indispensable for diagnosis. Stepwise categorization and disease classification by comprehensive and systemic checkup are very helpful for determining the causes of fever.