Haupt M T, Rackow E C
Am Heart J. 1983 May;105(5):763-8. doi: 10.1016/0002-8703(83)90238-7.
The hemodynamic characteristics of 36 febrile patients were studied when temperature was greater than 100 degrees F and after resolution of fever (temperature less than or equal to 100 degrees F). The patients were divided into those with bacterial infection (group I, n = 26) and those whose fever was noninfectious in etiology (group II, n = 10). Analysis of patients likely to have coronary artery disease (CAD) (subset A, n = 12) and those unlikely to have CAD (subset B, n = 7) was carried out. To maintain constant preload, pulmonary artery wedge pressure varied by not more than 2 mm Hg in all patients. Resolution of fever was associated with a 23% increase in stroke volume index (SVI) and 37% increase in left ventricular stroke work index (LVSWI) for group I (p less than 0.01). Group II showed a 27% increase in SVI and a 38% increase in LVSWI (p less than 0.05). Both subsets A and B showed significant increases in LVSWI after resolution of fever. We found evidence of decreased left ventricular performance during the febrile state in patients with and without infections. Since all groups and subsets maintained a normal or high cardiac index associated with increased heart rate during the febrile state, the tachycardic response of the febrile patient may serve to maintain cardiac output when myocardial performance is impaired.
对36例发热患者在体温高于100华氏度时以及热退（体温小于或等于100华氏度）后进行血流动力学特征研究。患者被分为细菌感染组（I组，n = 26）和病因非感染性发热组（II组，n = 10）。对可能患有冠状动脉疾病（CAD）的患者（A亚组，n = 12）和不太可能患有CAD的患者（B亚组，n = 7）进行了分析。为维持恒定的前负荷，所有患者的肺动脉楔压变化不超过2 mmHg。热退时，I组的每搏量指数（SVI）增加23%，左心室每搏功指数（LVSWI）增加37%（p < 0.01）。II组的SVI增加27%，LVSWI增加38%（p < 0.05）。A亚组和B亚组在热退后LVSWI均显著增加。我们发现，无论有无感染，发热状态下患者的左心室功能均有下降的证据。由于所有组和亚组在发热状态下均维持正常或较高的心指数并伴有心率增加，发热患者的心动过速反应可能在心肌功能受损时用于维持心输出量。
