不明原因发热的病因分布及临床特征

发布时间：2018-06-16 04:11

本文选题：不明原因发热 + 病因分布　；参考：《中国医学科学院学报》2011年01期

【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。
[Abstract]:Objective to investigate the etiological distribution and clinical features of FUO (fever of unknown origin). Methods the clinical data of 816 patients who were hospitalized in the Department of Internal Medicine of the Chinese people's Liberation Army General Hospital from January 2000 to January 2009 and who met the FUO diagnostic criteria were analyzed retrospectively. The etiology, diagnostic methods and clinical manifestations were summarized. A comparison was made between elderly patients and non-elderly patients. Results 766 out of 816 patients were diagnosed. These include 330 cases of infectious diseases, 40.4% of which are tuberculosis (49.775 / 330g), 281 cases of connective tissue disease (281 cases) and 34.4% (55.2% / 281% of adult Steele's disease), 89 cases of malignant tumors (10.9%), of which lymphoma is 56.22% / 89 (all lung cancers are complicated with obstructive pneumonia). There were 66 cases of other diseases, of which Crohn's disease accounted for 22.715 / 660.50 cases (6.1%) were not finally diagnosed. The proportion of infectious diseases and malignant tumors in elderly patients was 49.4% and 15.6%, respectively, which was significantly higher than that in non-elderly patients (32.0%) and 6.4% (P 0.0000), and the proportion of connective tissue diseases was 17.9%, which was significantly lower than that in non-elderly patients (50.1%). Conclusion most FUOs can be diagnosed by careful examination and analysis. Infectious diseases are the main cause of FUO, and tuberculosis is the most common cause of FUO, especially in elderly patients. Connective tissue disease and malignant tumor also account for a considerable proportion of FUO.
【作者单位】：中国人民解放军总医院南楼心血管一科;中国人民解放军总医院急诊科;
【分类号】：R441.3

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