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小儿发热的回顾性分析:我们过去5年的经验

Retrospective Analysis of Fever in Pediatric Age: Our Experience over the Last 5 Years.

作者信息

Valenzise Mariella, D'Amico Federica, La Barbera Giulia, Cassone Carlo Maria, Patafi Silvia, Lombardo Fortunato, Aversa Tommaso, Wasniewska Malgorzata Gabriela, Salzano Giuseppina, Morace Carmela

机构信息

Department of Human Pathology of the Adulthood and Childhood, University of Messina, 98121 Messina, Italy.

Department of Clinical and Sperimental Medicine, University of Messina, 98121 Messina, Italy.

出版信息

Children (Basel). 2024 Apr 30;11(5):539. doi: 10.3390/children11050539.

Abstract

BACKGROUND

Fever is one of the most frequent symptoms highlighted during medical assistance. Due to this great impact, our study has the purpose of analyzing the demographic and laboratory characteristics of patients hospitalized in our center and identifying predictive markers to make the differential diagnosis between infectious and non-infectious fever.

METHODS

Our population included 220 children, collected from January 2017 to August 2022, hospitalized for continuous fever (4 days or more in duration with at least one temperature peak ≥37.5 °C) and excluded cases of discharge against medical advice and/or transfer to other operating units. Demographic (mean age at the time of admission, frequency of hospitalization, and mean days of hospitalization), laboratory, and instrumental variables were analyzed in order to find correlation with fever etiology.

RESULTS

Older age at the time of hospitalization, family history of periodic fever, fever lasting more than 8 days, and longer hospitalization are strongly associated with non-infectious fever, together with anemia, high platelet count, high CRP and ferritin, and hyponatremia at the time of admission. Paracetamol is the preferred antipyretic treatment. Echocardiogram has shown anomalies in patients with infectious fever, while ECG anomalies were detected in non-infectious fever.

CONCLUSIONS

Our data underline the importance of predictive markers, such as clinical and laboratory parameters, to differentiate infectious from non-infectious fevers, but further studies are necessary.

摘要

背景

发热是医疗救助期间最常见的症状之一。鉴于其巨大影响,我们的研究旨在分析在我们中心住院患者的人口统计学和实验室特征,并确定预测标志物,以对感染性发热和非感染性发热进行鉴别诊断。

方法

我们的研究对象包括220名儿童,收集时间为2017年1月至2022年8月,因持续发热(持续4天或更长时间,至少有一个体温峰值≥37.5°C)住院,排除自动出院和/或转至其他科室的病例。分析人口统计学(入院时的平均年龄、住院频率和平均住院天数)、实验室和器械变量,以找出与发热病因的相关性。

结果

住院时年龄较大、周期性发热家族史、发热持续超过8天、住院时间较长与非感染性发热密切相关,同时入院时伴有贫血、血小板计数高、CRP和铁蛋白高以及低钠血症。对乙酰氨基酚是首选的退热治疗药物。超声心动图显示感染性发热患者有异常,而非感染性发热患者检测到心电图异常。

结论

我们的数据强调了预测标志物(如临床和实验室参数)在区分感染性发热和非感染性发热方面的重要性,但仍需进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90a7/11120056/3675b13591b4/children-11-00539-sch001.jpg

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