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Pannachet Rienvichit¹, Butsabong Lerkvaleekul², Nopporn Apiwattanakul³

¹Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

European journal of pediatrics

|June 18, 2025

概括

诊断出源不明的儿科发烧 (FUO) 是一个挑战. 一个新的预测模型有效地区分了儿童的感染,自身免疫性疾病和恶性瘤,有助于临床决策.

科学领域:

儿科医学儿科医学
临床流行病学临床流行病学
诊断的准确性诊断的准确性

背景情况:

在儿童中诊断出源不明的发烧 (FUO) 存在重大挑战,需要区分传染性,自身免疫性和恶性病因.
准确的诊断对于及时和适当的治疗至关重要,影响患者的治疗结果.

研究的目的:

开发和验证用于确定儿科FUO病因学的预测模型.
帮助儿科医生在患有FUO的儿童中区分感染,自身免疫性疾病和恶性瘤.

主要方法:

对儿童 (1-18岁) 的医疗记录的回顾性审查,FUO持续时间≥7天 (2007-2023年).
数据收集包括临床和实验室参数.
用于模型构建和验证的多项逻辑回归和预测边际分析,通过接受器运行特征曲线 (AUC) 下面的面积评估性能.

主要成果:

在发育队列 (n=240) 中,FUO的原因包括感染 (32.5%),自身免疫性疾病 (34.2%) 和恶性瘤 (33.3%).
确定了自身免疫性疾病的关键预测因素包括关节炎和长期发烧 (>30天).
恶性瘤的预测因素包括腹壮大,淋巴腺病,严重贫血,血小板缩和长期发烧;咳与自身免疫性疾病和恶性瘤相反相关.

结论:

开发了一种经过验证的预测模型,以帮助区分儿科FUO的原因.
该模型在感染,自身免疫性疾病和恶性瘤方面显示出良好的诊断性能 (AUC从0.82到0.88不等).
该工具支持儿童FUO病例的数据驱动决策.

关键词:

这是自身免疫性疾病.感染感染感染恶性瘤是一种恶性瘤.儿科儿科儿科长时间的发烧.

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