摘要
目的分析不明原因发热(FUO)患者的病因、临床特征和诊断方法,为FUO患者的诊治提供参考。方法回顾性分析2005年1月-2010年12月同济医院感染科收治的符合FUO诊断标准的340例患者的临床资料,总结病因、诊断方法和临床特征,分析病因与患者性别、年龄以及发热时间的关系,了解疾病谱的变迁特点。结果 340例患者中最终明确诊断295例(86.8%)。病因分类:感染性疾病150例(44.1%),非感染性疾病145例(42.7%),病因不明者45例(13.2%)。所有患者中,男186例(54.7%),女154例(45.3%)。男女性别在疾病分布比例上无明显差异,但女性结缔组织病比例明显高于男性,男性淋巴瘤发病率明显高于女性。年龄分布上以实体肿瘤的发病年龄(48.4±17.2岁)最高,而成人Still病的发病年龄(27.4±11.9岁)最低。热程:≤4周202例(59.4%),4～8周50例(14.7%),>8周88例(25.9%)。其中以结缔组织病、淋巴瘤和结核的平均热程最长。结论 FUO患者经过详细询问病史、查体和各种检查,大部分可以确诊,其病因仍然以感染为主。不同性别、年龄、发热时间的患者疾病谱有所不同。
Objective To analyze the etiology, clinical characteristics and diagnostic methods of fever of unknown origin （FUO）, so as to provide a reference for the diagnosis and treatment of FUE. Methods The clinical data of 340 patients with FUO admitted in Tongji Hospital from Jan. 2005 to Dec. 2010 were retrospectively analyzed. The relationship between etiology and gender, age of the patients, and course of fever were comprehensively evaluated, and the diversity of disease spectrum was also analyzed. Results Among the 340 patients analyzed, 295（86.76%） the diagnosis was definitely made. As to the etiology, 150（50.85%） were suffering from infectious diseases, 145（49.15%） non-infectious diseases, and in 45（13.24%） the etiology remained unknown till they were discharged from hospital. Among all of the patients, 186（54.71%） were male and 154（45.29%） were female. No significant difference existed in the ratio of disease distribution between male and female patients, but the incidence of connective tissue disease was significantly higher in female patients than in male patients, while the incidence of lymphoma was significantly higher in male patients than in females. As to the age distribution of the disease, 66 patients （19.41%） were younger than 20 years old, 98 patients （28.82%） were 21-40, 136（40.00%） were 41-60, and 40（11.76%） were older than 60. The mean age of patients suffering from solid tumors was the highest （48.4 ± 17.2 years）, and that of adult Still disease was youngest （27.4 ± 11.9 years）. The course of fever in 202 patients （59.41%） was shorter than 4 weeks, that of 50 patients （14.71%） was 4-8 weeks, and in 88 patients （25.88%） it was longer than 8 weeks. Febrile course was longest in patients suffering from connective tissue disease, lymphoma and tuberculosis. Conclusions Most of the patients with FUO could be definitely diagnosed prudent inquiry of history, followed by scrupulous physical examination, aided by appropriate instrumental examination, most cases of FUO could be definitely diagnosis. Among these patients, infectious diseases remain the main causes of FUO. The disease spectrum will be diverse due to different gender, age and course of fever.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2013年第3期217-221,共5页
Medical Journal of Chinese People's Liberation Army
关键词
发热
原因不明
诊断
回顾性研究
fever of unknown origin
diagnosis
retrospective studies
作者简介
[通讯作者]齐俊英，E-mail：jyqi@tjh．tjmu．edu．cn
