不明原因发热449例临床分析  

A clinical review of 449 cases with fever of unknown origin

作　　者：马小军[1] 王爱霞[1] 邓国华[1] 盛瑞媛[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院感染内科,100730

出　　处：《中华内科杂志》2004年第9期682-685,共4页Chinese Journal of Internal Medicine

摘　　要：目的　探讨不明原因发热 (FUO)的原因。方法　回顾性分析 2 0 0 0年 1月～ 2 0 0 3年12月间在我院住院诊治的符合不明原因发热诊断标准的患者 4 4 9例。结果　 4 4 9例患者中经各种检查或诊断性治疗最终明确诊断者 387例 ,确诊率为 86 2 %。病因包括 :感染性疾病 2 2 0例 (5 6 8% ) ,其中结核病 96例 ,占 4 3 6 % (96 /2 2 0 ) ;结缔组织病 76例 (19 6 % ) ,其中Still病占 34 2 % (2 6 /76 ) ,系统性红斑狼疮占 18 4 % (14 /76 ) ,血管炎占 13 2 % (10 /76 ) ;肿瘤性疾病 6 4例 (16 5 % ) ,其中淋巴瘤占 39 1% (2 5 /6 4 ) ;其他疾病 2 7例 (7 0 % ) ,其中坏死性淋巴结炎占 33 3% (9/2 7) ,伪热占 2 2 2 % (6 /2 7) ,药物热占 2 6 % (7/2 7) ;出院时仍未确诊的 6 2例 (13 8% )。结论　感染性疾病是本组FUO患者的主要病因 ,结核病是其中的主要病种 ,结缔组织病和肿瘤性疾病在本组FUO病因中也占重要地位 ;Objective To investigate the causes of fever of unknown origin (FUO).Methods The clinical data were retrospectively analyzed from patients with FUO hospitalized in Peking Union Medical College Hospital from January 2000 to December 2003. During that period of time, 449 cases fulfilled the criteria of FUO. Results Out of the 449 FUO cases, definite diagnosis was eventually achieved in 387 patients (86.9%). The most common causes of FUO were infectious diseases (56.8%), with tuberculosis accounting for 43.6% of cases of infection. Seventy-six patients were suffered from collagen vascular diseases (CVD): with Still′s disease, systemic lupus erythematosus and vasculitis accounting for 34.2% (26/76), 18.4% (14/76) and 13.2% (10/76) of the this category, respectively. 16.5% (64/449) of the FUO cases were diagnosed as malignancy. Miscellaneous causes were found in 7.0% of the FUO cases. However, no definite diagnosis had been made in the remaining 62 (13.8%) cases until they discharged from the hospital.Conclusions In most FUO cases the causes can be diagnosed eventually after careful analysis of clinical data. While infectious diseases, especially tuberculosis, were still the most common causes of FUO, CVD and malignancy were also major causes of FUO and the incidence of malignancy were increased with the time.

关 键 词：不明原因发热 FUO 患者 肿瘤性疾病 确诊 结缔组织病 感染性疾病 诊治 病因 临床检查 

分 类 号：R441[医药卫生—诊断学]