Program in Clinical and Experimental Therapeutics, University of Georgia College of Pharmacy, Augusta, Georgia, USA.
Pharmacotherapy. 2011 Nov;31(11):1085-91. doi: 10.1592/phco.31.11.1085.
Approximately 50% of patients hospitalized for stroke develop fever. In fact, experimental evidence suggests that high body temperature is significantly correlated to initial stroke severity, lesion size, mortality, and neurologic outcome. Fever occurring after stroke is associated with poor outcomes. We investigated the etiology of fever after stroke and present evidence evaluating the efficacy and safety of interventions used to treat stroke-associated fever. Oral antipyretics are only marginally effective in lowering elevated body temperature in this population and may have unintended adverse consequences. Nonpharmacologic approaches to cooling have been more effective in achieving normothermia, but whether stroke outcomes can be improved remains unclear. We recommend using body temperature as a biomarker and a catalyst for aggressive investigation for an infectious etiology. Care must be taken not to exceed the new standard of a maximum acetaminophen dose of 3 g/day to avoid patient harm.
约 50%的脑卒中住院患者会发热。实际上，实验证据表明，体温升高与初始脑卒中严重程度、病灶大小、死亡率和神经功能预后显著相关。脑卒中后发热与不良预后相关。我们研究了脑卒中后发热的病因，并提供了评估干预措施治疗脑卒中相关性发热的疗效和安全性的证据。在该人群中，口服解热药仅能轻微降低升高的体温，并且可能产生意想不到的不良后果。非药物降温方法在达到正常体温方面更有效，但脑卒中结局是否可以改善仍不清楚。我们建议将体温作为生物标志物和催化剂，以积极探寻感染性病因。必须注意不要超过新的最大乙酰氨基酚剂量标准（3 g/天），以避免患者受到伤害。
