CAJ | 학술논문

目的：探讨不明原因发热(fever of unknown origin，FUO)与感染性疾病相关的因素。方法回顾性分析本院发热疾病科2009年12月-2011年12月符合FUO诊断标准的病例503例，其中明确诊断454例，分为感染性疾病组和非感染性疾病组，采用单因素与多因素非条件Logistic回归分析，筛选与感染性疾病相关的因素，并建立Logistic回归模型。结果经单因素和多因素Logistic回归分析，最终筛选出6个与感染性疾病相关的因素，分别为关节痛、病程、体重减轻、血清碱性磷酸酶(ALP)、血清铁蛋白(SF)、中性粒细胞比例(N)。回归模型方程为：Logit(p)=12.707-1.613×关节痛-0.016×病程-0.878×体重减轻-0.011×AKP-0.001×SF-0.097×N，其ROC曲线下面积为0.8579。Logit(p)最佳诊断临界值为2.32，判断个体是否感染性疾病的灵敏度为68.35%，特异度为89.33%。结论关节痛、病程、体重减轻、ALP、SF、N是FUO中与感染性疾病相关的影响因素，Logistic回归模型ROC曲线下面积为0.8579、灵敏度为68.35%、特异度为89.33%，诊断效能较好。
목적：탐토불명원인발열(fever of unknown origin，FUO)여감염성질병상관적인소。방법회고성분석본원발열질병과2009년12월-2011년12월부합FUO진단표준적병례503례，기중명학진단454례，분위감염성질병조화비감염성질병조，채용단인소여다인소비조건Logistic회귀분석，사선여감염성질병상관적인소，병건립Logistic회귀모형。결과경단인소화다인소Logistic회귀분석，최종사선출6개여감염성질병상관적인소，분별위관절통、병정、체중감경、혈청감성린산매(ALP)、혈청철단백(SF)、중성립세포비례(N)。회귀모형방정위：Logit(p)=12.707-1.613×관절통-0.016×병정-0.878×체중감경-0.011×AKP-0.001×SF-0.097×N，기ROC곡선하면적위0.8579。Logit(p)최가진단림계치위2.32，판단개체시부감염성질병적령민도위68.35%，특이도위89.33%。결론관절통、병정、체중감경、ALP、SF、N시FUO중여감염성질병상관적영향인소，Logistic회귀모형ROC곡선하면적위0.8579、령민도위68.35%、특이도위89.33%，진단효능교호。
Objective To study the infectious diseases-related factors in fever of unknown origin (FUO).Methods Five hundred and three patients (454 were diagnosed with FUO) admitted to our department from December 2009 to December 2011 were retrospectively analyzed. The 454 cases were divided into infectious disease group and non-infectious disease group. Their infectious diseases-related factors were analyzed by univariate and multivariate logistic regression analysis, respectively. A logistic regression model was established.Results Univariate and multivariate logistic regression analysis showed that arthralgia, course of disease, weight loss, ALP, SF, and neutrophils (N) were the infectious diseases-related factors. Their regression equation: Logit (p) = 12.707-1.613× arthralgia- 0.016× course of fever - 0.878× weight loss - 0.011×ALP- 0.001×SF-0.097×N. The area under the ROC curve was 0.857 9. The optimal cut off value was 2.32, the sensitivity was 68.35 %, and the specificity was 89.33%.Conclusion Arthralgia, curse of fever, weight loss, ALP, SF and N are the infectious diseases-related factors. The area under the ROC curve is 0.857 9,the sensitivity is 68.35 %, and specificity is 89.33% in logistic regression model.