Suzumoto Masaki, Hotomi Muneki, Billal Dewan S, Fujihara Keiji, Harabuchi Yasuaki, Yamanaka Noboru
Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, 811-1 Wakayama-shi, Wakayama 641-8510, Japan.
Auris Nasus Larynx. 2009 Jun;36(3):314-20. doi: 10.1016/j.anl.2008.07.001. Epub 2008 Sep 5.
The aim of this study was to develop and evaluate a scoring system for the management of acute pharyngo-tonsillitis.
We conducted a prospective study between May 2004 and June 2005. Patients with acute pharyngo-tonsillitis were evaluated for causative pathogens and were assessed clinical symptoms and pharyngo-tonsillar finding by a clinical scoring system.
A total 214 adult patients were enrolled in this study. Streptococcus pyogenes were identified at 13.6%. Thirty-one viruses were also identified by PCR. They were adenovirus (4.8%), influenza virus (1.0%), RS virus (6.3%), and human metapneumovirus (2.9%). Numbers of total white blood cells and levels of C-reactive protein showed a significant positive correlation with clinical scores (p<0.001) and were also higher in cases with S. pyogenes. The clinical scores rapidly improved after the antimicrobial treatments in moderate cases and severe cases.
The current study strongly suggested that the clinical scoring system reflected disease severity well and would be very useful for evaluating clinical course and decision making for the antimicrobial treatment of acute pharyngo-tonisllitis.
本研究旨在开发并评估一种用于急性咽扁桃体炎管理的评分系统。
我们在2004年5月至2005年6月期间进行了一项前瞻性研究。对急性咽扁桃体炎患者进行致病病原体评估，并通过临床评分系统评估临床症状和咽扁桃体表现。
本研究共纳入214例成年患者。化脓性链球菌的检出率为13.6%。通过聚合酶链反应还鉴定出31种病毒。它们分别是腺病毒（4.8%）、流感病毒（1.0%）、呼吸道合胞病毒（6.3%）和人偏肺病毒（2.9%）。白细胞总数和C反应蛋白水平与临床评分呈显著正相关（p<0.001），且在化脓性链球菌感染病例中也更高。中度和重度病例在接受抗菌治疗后临床评分迅速改善。
当前研究强烈表明，临床评分系统能很好地反映疾病严重程度，对评估急性咽扁桃体炎的临床病程及抗菌治疗决策非常有用。
