Bonadio W A, Bellomo T, Brady W, Smith D
Department of Pediatrics, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee.
Clin Pediatr (Phila). 1993 Jun;32(6):343-6. doi: 10.1177/000992289303200604.
We reviewed the body-temperature patterns of 140 children ages 2 to 24 months who had fever > or = 39.0 degrees C, received acetaminophen 10 to 15 mg/kg, and had their temperatures remeasured 60 to 90 min later. The children comprised three groups: 22 had bacterial meningitis; 59, isolated bacteremia; and 59, nonbacterial febrile illness. Percentages of patients who became afebrile (temperature < 38.0 degrees C) after receiving acetaminophen were not significantly different among the three groups. Differences in mean temperature decrease after antipyretic was given were significant within each group but not between groups. An inverse relation (P < .004) between patient age and magnitude of temperature was revealed by the following formula: degrees C of defervescence = 1.66 - (0.028 x patient age in months). Thus, highly febrile young children with and without invasive bacterial infections who receive a therapeutic dose of acetaminophen experience a significant temperature drop after 60 to 90 min but do not commonly defervesce to an afebrile state. The degree of defervescence is age-dependent and does not distinguish between infectious outcomes.
我们回顾了140名2至24个月大儿童的体温模式，这些儿童体温≥39.0℃，接受了10至15mg/kg的对乙酰氨基酚治疗，并在60至90分钟后重新测量体温。这些儿童分为三组：22例患有细菌性脑膜炎；59例为单纯菌血症；59例为非细菌性发热性疾病。三组中接受对乙酰氨基酚治疗后体温恢复正常（体温<38.0℃）的患者百分比无显著差异。每组内给予退烧药后平均体温下降幅度存在显著差异，但组间无差异。通过以下公式揭示了患者年龄与体温下降幅度之间的负相关关系（P<0.004）：体温下降度数（℃）=1.66 - （0.028×患者月龄）。因此，接受治疗剂量对乙酰氨基酚的高热幼儿，无论有无侵袭性细菌感染，在60至90分钟后体温都会显著下降，但通常不会降至正常体温。体温下降程度与年龄有关，且无法区分感染结果。
