儿童不明原因发热主要病因及临床特征分析  

Analysis of the Main Etiology and Clinical Characteristics of Unexplained Fever in Children

作　　者：刘飞 朱春晖[1] 刘金明 程兰[3] LIU Fei;ZHU Chunhui;LIU Jinming;CHENG Lan;无(Department of Infectious Diseases,Jiangxi Children’s Hospital,Nanchang,Jiangxi 330006,China;Department of General Pediatrics,Xingguo County Maternal and Child Health Hospital,Ganzhou,Jiangxi,341000,China;Department of Hematology,Jiangxi Children’s Hospital,Nanchang,Jiangxi 330006,China)

机构地区：[1]江西省儿童医院感染科,江西南昌330006 [2]江西省赣州市兴国县妇幼保健院普儿科,江西赣州341000 [3]江西省儿童医院血液科,江西南昌330006

出　　处：《中国医药指南》2025年第11期5-7,共3页Guide of China Medicine

基　　金：江西省卫生健康委科技计划(202311039)。

摘　　要：目的对儿童不明原因发热主要病因及临床特征分析。方法选取江西省儿童医院2011年1月至2021年12月收治的63例不明原因发热患儿进行研究,依据疾病种类分感染组(27例)、肿瘤组(18例)、非感染组(11例)、其他组(7例),对比患儿资料,对儿童不明原因发热的主要特征进行描述,分析儿童不明原因发热的主要因素。结果同组别患儿年龄差异有统计意义(P<0.05)。不同年龄段易患疾病种类对比,差异有统计学意义(P<0.05)。其中≥1~<3岁感染性疾病占同年龄层的61.54%(8/13),≥1~<3岁和≥3~<6岁感染性疾病及非感染性炎症性疾病占同年龄层的69.57%(16/23)和60.00%(12/20),≥6岁非感染性炎症性疾病占同年龄层的45.45%(5/11)。感染组、非感染、肿瘤组发热急性期接受血清炎症因子检验,感染组热程长于非感染组和肿瘤组(P<0.05),感染组白细胞介素-6(IL-6)分别低于非感染组和肿瘤组(P<0.05)。3组白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(均P>0.05)。结论6岁以下的儿童出现不明原因的发热时,感染性疾病是主要的致病因素,且男童发病率比女童发病率高,随着年龄的增长,肿瘤疾病及非感染性疾病的患儿病率逐渐升高。各类疾病中,感染性疾病的热程最长,而在急性发热期间,感染性疾病患儿IL-6水平明显低于肿瘤疾病和非感染性疾病。Objective Analysis of the main causes and clinical characteristics of unexplained fever in children.Methods A total of 63 children with fever of unknown origin admitted to the Children’s Hospital of Jiangxi Province from January 2011 to December 2021 were selected for the study.The children were divided into four groups based on disease categories:the infection group(27 cases),the tumor group(18 cases),the non-infection group(11 cases),and the other group(7 cases).The study compared the clinical data of the children to describe the main characteristics of fever of unknown origin in children and analyze the primary factors contributing to this condition.Results Age differences within the same group were significant(P<0.05).Differences in disease types across age groups were also significant(P<0.05).Specifically,in children aged≥1 to<3 years,infectious diseases accounted for 61.54%(8/13).In children aged≥1 to<3 years and≥3 to<6 years,infectious and non-infectious inflammatory diseases accounted for 69.57%(16/23)and 60.00%(12/20),respectively.In children aged≥6 years,non-infectious inflammatory diseases accounted for 45.45%(5/11).During the acute febrile phase,children in the infection,non-infection,and tumor groups underwent serum inflammatory factor tests.The infection group had a longer fever duration than the non-infection and tumor groups(P<0.05).IL-6 levels were lower in the infection group than in the non-infection and tumor groups(P<0.05).However,no significant differences were found in IL-10 and TNF-αlevels among the three groups(all P>0.05).Conclusions Infectious diseases are the primary cause of unidentified fever in children under 6 years of age,with a higher incidence among males.As age increases,the incidence of tumor diseases and non-infectious conditions gradually rises.Among various diseases,infectious diseases are associated with the longest fever duration,and children with infectious diseases exhibit significantly lower IL-6 levels during acute fever compared to those with tumor disease

关 键 词：不明原因发热 危险因素 感染性疾病 血清炎症因子 疾病特征 

分 类 号：R720.597[医药卫生—急诊医学]