不明原因发热病例报告的临床分析  

Clinical study on pathogenic causes for FUO cases

作　　者：徐定华[1] 石秋萍[1] 王超[1] 王红[1] 张淑文[1] 

机构地区：[1]首都医科大学附属北京友谊医院感染内科

出　　处：《临床和实验医学杂志》2014年第4期335-336,F0003,共3页Journal of Clinical and Experimental Medicine

基　　金：首都医学发展科研基金项目(项目编号:2009-1034)

摘　　要：目的回顾性分析国外不明原因发热相关病例报道,为临床不明原因发热的病因诊断提供参考。方法以"fever of unknown origin"为检索词,检索到PubMed数据库内2008年5月至2013年5月的相关文献190篇,对其中资料完善的107篇文献共127例患者不明原因发热的病因进行分析。结果 107篇文献中的127例患者中,感染性疾病49例(38.6%),非感染性炎性疾病40例(31.5%),肿瘤性疾病23例(18.1%),其他原因14例(11.0%)。49例感染性疾病中,以细菌感染14例(28.6%)最多见;40例非感染性炎性疾病中以血管炎14例(35%)最多见;23例肿瘤性疾病中以淋巴瘤14例(60.9%)最多见;14例其他原因中以药物热4例(28.6%)最多见。结论引起不明原因发热的病因众多,可分为感染性疾病、非感染性炎症疾病和肿瘤性疾病及其他。本组资料显示,感染性疾病是不明原因发热相关病例报道中最常见的病因,血管炎和淋巴瘤分别占非感染性炎性疾病和肿瘤性疾病中的首位。Objective To analyze the case reports of fever of unknown origin （FUO） in PubMed in order to improve the level of clinical diagnosis for FUO. Methods According to the search term ＂fever of unknown origin＂ , a total of 127 cases of fever of unknown origin from 107 papers during May 2008 to May 2013 were collected in the data base of PubMed. The case reports dealing with fever of unknown origin were ana- lyzed to determine the pathogenic origin. Results The distribution of cases with FUO was as follows ： 49 cases （ 38.6 ） with infective diseases, 40 cases （31.5 % ） with connective tissue diseases, 23 cases （18.1% ） with malignant tumors, and l g cases （11.0% ） with other kind of diseases. Among 49 cases with infective diseases, bacterial infection occupied the most common place, accounted for 28.6% （lg cases）. Among 40 cases with connective tissue diseases, vasculitis was the most common cause accounted for 35% （ 14 cases）. Among 23 cases with malignant tumors, lymphoma was the most common origin accounted for 60.9% （ 14 cases＇）. In 14 cases with other kind of diseases, drug fever was the most common origin accounted for 28.6% （4 cases）. Conclusion The pathogenic causes of fever with unknown origin are various, including infective disea- ses, non - infective diseases, malignant tumors and other kind of diseases. The bacterial infection is the most common cause in infective diseases for FUO, and vasculitis and lymphoma are the most common causes in non - infective diseases responsible for FUO .

关 键 词：不明原因发热 病例报告 文献分析 

分 类 号：R441.3[医药卫生—诊断学]