在未知来源的医院发烧中,毒查工具,素和C反应蛋白的诊断效用
Shashikant Saini1, Sapna Pahil2, Ritin Mohindra1
1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
World journal of critical care medicine
|August 29, 2025
概括
毒查工具和生物标志物,如前素 (PCT) 和C反应蛋白 (CRP),在诊断严重病情的成年人中未知来源的医院发烧 (nFUO) 的传染病因的准确性有限. 这些标志物不应是初步临床决定的唯一依据.
科学领域:
- 危急护理医学
- 传染性疾病
- 诊断的准确性
背景情况:
- 源不明的鼻腔热 (nFUO) 具有多种原因的诊断挑战.
- 对于nFUO的败血症查工具和生物标志物的诊断性能的证据有限.
- 准确区分传染性和非传染性病因对于及时治疗至关重要.
研究的目的:
- 评估常见的败血症查工具和生物标志物的诊断效用.
- 确定这些标志物是否可以区分严重病情的nFUO的传染性和非传染性原因.
- 在发烧开始时评估表现.
主要方法:
- 在急症急诊医疗病房进行前性观察研究.
- 包括符合Durack和Street nFUO标准的患者.
- 使用ROC曲线分析对毒查工具 (SIRS,SOFA,qSOFA,NEWS,MEWS) 和生物标志物 (PCT,CRP) 的评估.
主要成果:
- 败血症工具的诊断准确性很差 (AUC接近0. 5).
- 在非传染病例中,前素 (PCT) 的性能较低 (AUC=0. 61),而C反应蛋白 (CRP) 的性能较高 (AUC=0. 45).
- 发现了传染性原因 (肺炎,血流感染) 和非传染性原因 (中心发烧,血栓炎);18. 8% 仍未确诊.
结论:
- 毒查工具,PCT和CRP在诊断严重病情的成年人中具有有限的价值.
- 这些标记单独不足以指导初步诊断和治疗决策.
- 可能需要进一步的研究来确定更有效的诊断策略.
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