发热伴淋巴结肿大初诊 163 例病因及临床特征分析  

Etiological distribution and clinical characteristics of 163 cases with fever combined with lymphadenopathy at first visit

作　　者：袁剑伟 王艳[1] 李雅琴[2] 王琳[1] 王宏霞[1] 任圆 YUAN Jianwei;WANG Yan;LI Yaqin;WANG Lin;WANG Hongxia;REN Yuan(Department of Infectious Diseases,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan,Shanxi 030032,China;Department of Pathology,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan,Shanxi 030032,China;School of Public Health,Shanxi Medical University,Taiyuan,Shanxi 030032,China)

机构地区：[1]山西医科大学第三医院(山西白求恩医院山西医学科学院同济山西医院)感染病科,山西太原030032 [2]山西医科大学第三医院(山西白求恩医院山西医学科学院同济山西医院)病理科,山西太原030032 [3]山西医科大学公共卫生学院,山西太原030032

出　　处：《安徽医药》2024年第6期1197-1202,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨以发热伴淋巴结肿大为特征疾病初诊病人的病因分布及临床特征,提高临床对该疾病的认知和诊断能力。方法收集2020年1月至2022年10月在山西白求恩医院初次收治的经淋巴结活检及病理检查诊断明确的163例发热伴淋巴结肿大病人,根据病因分为感染性疾病组(感染组)、非感染性炎症性疾病组(非感染组)、肿瘤性疾病及造血系统疾病组(肿瘤及造血组)、其他类疾病组(其他组),对其性别、年龄、热程、淋巴结肿大特征、伴随症状、实验室资料、淋巴结病理等资料进行分析。结果163例病人中,感染组63例(38.7%)、非感染组32例(19.6%)、肿瘤及造血组31例(19.0%)、其他组37例(22.7%)。临床特征中,四组间性别、年龄、淋巴结压痛、淋巴结肿大部位(头颈部/胸部/腹部)、合并全身性淋巴结肿大、半年内体质量下降≥10%均差异有统计学意义(均P<0.05)。实验室检查结果中,四组间白细胞计数、中性粒细胞百分比、血小板计数、总胆红素、C反应蛋白、降钙素原、红细胞沉降率、抗核抗体阳性均差异有统计学意义(均P<0.05)。结论发热伴淋巴结肿大主要病因是感染性疾病,其次为其他类疾病,前者病毒感染多见,后者以组织坏死性淋巴结炎为主。临床可通过病人基本情况、临床特征、实验室检查进行初步鉴别诊断,淋巴结活检对诊疗有一定帮助。Objective To investigate the etiological distribution and clinical characteristics of patients with a disease characterized by fever combined with lymphadenopathy at first visit and improve the clinical cognition and diagnosability of the disease.Methods From January 2020 to October 2022,163 patients with fever combined with lymphadenopathy definitely diagnosed by lymph node biopsy and pathological examination for the first visit to Shanxi Bethune Hospital were collected and retrospectively analyzed.According to the etiology, they were divided into the infectious disease group (the "infection group"), the non-infectious inflammatory disease group (the "non-infection group"), the neoplastic disease and hematopoietic system disease group (the "neoplasm and hematopoiesis group"), and the group of other diseases (the "other group"). The clinical data of gender, age, duration of fever, characteristics of lymphadenopa-thy, accompanying symptoms, laboratory tests, lymph node pathology and other data were analyzed.Results Among the 163 patients, there were 63 (38.7%) in the infection group, 32 (19.6%) in the non-infection group, 31 (19.0%) in the neoplasm and hematopoiesis group, and 37 (22.7%) in the other group. As for the clinical characteristics, the gender, age, tenderness of lymph nodes, location of lymphadenopathy (head and neck/thorax/abdomen), generalized lymphadenopathy, and body weight loss within six months ≥ 10% showed statistically significant differences among the four groups (all P<0.05). According to the laboratory results, statistically signifi-cant differences were found in leukocyte count, neutrophil percentage, platelet count, total bilirubin, C-reactive protein, procalcitonin, erythrocyte sedimentation rate, and positive antinuclear antibodies among the four groups (all P<0.05).Conclusions The etiology of a fever combined with lymphadenopathy is mainly infectious diseases, followed by other diseases, the former is more common with viral infections, and the latter is dominated by necrotizing lympha

关 键 词：发热 淋巴结肿大 病因 临床特征 传染病 

分 类 号：R441[医药卫生—诊断学]