CAJ | 학술논문

目的：评价临床常用炎症指标对不明原因发热（ FUO）的诊断价值。方法回顾性分析2003年1月至2013年8月期间符合 FUO 诊断标准的病人372例。入选病例根据病因分组，对感染性疾病、风湿免疫性疾病、肿瘤性疾病3组，对共303例病例的白细胞计数（WBC）、C 反应蛋白（CRP）、降钙素原（PCT）和铁蛋白（SF）进行分析比较。结果303例 FUO 中，感染性疾病组224例（73.9%），风湿免疫性疾病组48例（15.8%），肿瘤性疾病组31例（10.2%）。不同疾病组间 WBC 水平不同，风湿免疫组的 WBC 水平较高，而感染性疾病组的 WBC 水平较低，差异有统计学意义；不同疾病组的 CRP 水平不同，肿瘤性疾病组的 CRP 明显升高，且高于感染性疾病组和风湿免疫组，差异有统计学意义；风湿免疫组的 SF 水平高于其他另两组，差异有统计学意义；ROC 曲线分析提示 WBC（入院第1天，入院第7天）、CRP、PCT和 SF 的曲线下面积（AUC）分别是0.581，0.550，0.728，0.769和0.648，其中，只有 CRP 的差异具有统计学意义。结论：在FUO 患者中，WBC、CRP、PCT、SF 对其病因的经验性诊断有一定的价值。
목적：평개림상상용염증지표대불명원인발열（ FUO）적진단개치。방법회고성분석2003년1월지2013년8월기간부합 FUO 진단표준적병인372례。입선병례근거병인분조，대감염성질병、풍습면역성질병、종류성질병3조，대공303례병례적백세포계수（WBC）、C 반응단백（CRP）、강개소원（PCT）화철단백（SF）진행분석비교。결과303례 FUO 중，감염성질병조224례（73.9%），풍습면역성질병조48례（15.8%），종류성질병조31례（10.2%）。불동질병조간 WBC 수평불동，풍습면역조적 WBC 수평교고，이감염성질병조적 WBC 수평교저，차이유통계학의의；불동질병조적 CRP 수평불동，종류성질병조적 CRP 명현승고，차고우감염성질병조화풍습면역조，차이유통계학의의；풍습면역조적 SF 수평고우기타령량조，차이유통계학의의；ROC 곡선분석제시 WBC（입원제1천，입원제7천）、CRP、PCT화 SF 적곡선하면적（AUC）분별시0.581，0.550，0.728，0.769화0.648，기중，지유 CRP 적차이구유통계학의의。결론：재FUO 환자중，WBC、CRP、PCT、SF 대기병인적경험성진단유일정적개치。
Objective To evaluate the diagnostic value of clinical common inflammatory markers on fever of unknown origin. Methods A total of 372 patients with fever of unknown origin in our hospital were collected from January 2003 to August 2013. The clinical data of these patients were analyzed retrospectively. 372 patients were divided into 3 groups according to the causes of FUO. WBC,CRP,PCT,ferritin of infectious,rheu-matic autoimmune,tumor 3 groups of 303 patients were analyzed and compared. Results In the 303 cases of FUO,the infectious disease group in-cluded 224 cases(73. 9% ),48 cases were classified as rheumatic autoimmune disease group(15. 8% ),31 cases were classified as tumor disease group(10. 2% ). WBC were different among the three groups. The WBC of the rheumatic autoimmune group was higher than the other 2 groups, while that of infectious group was the lowest. The difference was statistically significant. CRP were different among the three groups. The CRP value of tumor group was significantly elevated and higher than that of infectious and rheumatic autoimmune groups. The difference was statistically signifi-cant. The ferritin value of rheumatic autoimmune was higher than the other 2 groups. The difference was statistically significant. The ROC curve anal-ysis showed that AUC of WBC(the first day and the seventh day admitted),CRP,PCT,ferritin were 0. 581,0. 550,0. 728,0. 769 and 0. 648 re-spectively. And only the AUC of CRP was significant different. Conclusion The detection of WBC,CRP,PCT and ferritin has important clinical value in the empirical diagnosis of causes of patients with FUO.