不明原因发热的病因分布及临床特征  

Etiology and Clinical Features of Fever of Unknown Origin

作　　者：马锦玲[1] 曹剑[1] 王玉堂[1] 郭园园[1] 孟庆义[2] 

机构地区：[1]中国人民解放军总医院南楼心血管一科,北京100853 [2]中国人民解放军总医院急诊科,北京100853

出　　处：《中国医学科学院学报》2011年第1期83-87,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨不明原因发热(FUO)的病因分布及临床特征。方法回顾性分析2000年1月至2009年1月在中国人民解放军总医院内科住院且符合FUO诊断标准的816例患者的临床资料,总结了病因、诊断方法和临床表现,并在老年患者与非老年患者间进行了比较。结果 816例患者中,766例(93.9%)最终确诊,包括:感染性疾病330例(40.4%),其中结核病占49.7%(164/330);结缔组织病281例(34.4%),其中成人斯蒂尔病占55.2%(155/281);恶性肿瘤89例(10.9%),其中淋巴瘤占56.2%(50/89),所有肺癌均合并有阻塞性肺炎;其他疾病66例(8.1%),其中克罗恩病占22.7%(15/66)。50例患者(6.1%)最终未确诊。老年患者中感染性疾病和恶性肿瘤所占比例分别为49.4%和15.6%,明显高于非老年患者的32.0%(P=0.0000)和6.4%(P=0.0000);结缔组织病所占比例为17.9%,明显低于非老年患者的50.1%(P=0.0000)。结论大多数FUO通过仔细检查和分析可最终确诊。感染性疾病是FUO的主要病因,其中结核所占比例最高,以老年患者多见。结缔组织病和恶性肿瘤在FUO中也占有相当比例。Objective To investigate the etiology and clinical features of fever of unknown origin（FUO）.Methods The clinical data including etiology,diagnostic approaches,and clinical features were retrospectively analyzed in 816 patients with FUO who were presented in our department from January 2000 to January 2009.Results Of these 816 FUO cases,766（93.9%） were confirmed to be with infective diseases（40.4%,n=330）,connective tissue diseases（34.4%,n=281）,malignant tumors（10.9%,n=89）,other known diseases（8.1%,n=66）,and unknown diseases（6.1%,n=50）.The most common infective disease was tuberculosis（49.7%,164/330）,the most common connective tissue disease was adult-onset Still＇s disease（AOSD）（55.2%,155/281）,the most common malignant tumor was lymphoma（56.2%,50/89）,and the most common ＂other known disease＂ was Crohn＇s disease（22.7%,15/66）.All lung cancer cases had obstructive pneumonia.Significantly more elderly patients suffered from infective diseases（49.4% vs.32.0%） and malignant tumor（15.6% vs.6.4%） compared with the non-elderly（both P=0.0000）,while the proportion of connective tissue diseases was significantly less than that of the non-elderly（17.9% vs.50.1%,P=0.0000）.Conclusions Most FUO can be confirmed after careful examinations and analysis.The main cause of FUO is infective diseases,especially tuberculosis in the elderly.The connective tissue diseases and malignant tumors are also important causes.

关 键 词：不明原因发热 病因分布 临床特征 

分 类 号：R441.3[医药卫生—诊断学]