不明原因发热126例临床探讨

Analysis of the fever of unknown origin in 126 patients

目的探讨不明原因发热(FUO)患者的病因谱和诊断方法。方法回顾性分析2000-02～2007-10间在我院住院并符合FUO诊断标准的126例患者临床资料。结果126例患者中经多种检查或诊断性治疗,最后确诊119例,确诊率为94.44%。病因包括感染性疾病64例(50.79%),其中结核20例(占感染病例的31.25%);肿瘤疾病31例(24.6%);结缔组织疾病20例(15.87%);其他疾病4例(3.17%);病因未明者7例(5.56%)。结论感染性疾病仍是本组FUO的主要病因,肺外结核是其中的主要病种。肿瘤性疾病中以淋巴/血液肿瘤为主,结缔组织病中成人斯蒂尔病(AOSD)有明显增多。FUO诊断检查应程序化,及时进行细菌学培养、B超和CT检查。必要时给予多次穿刺、活检术及创伤性检查,有助于病因确诊和治疗。

Objective To analyse the characteristics and diagnostic method in the patients with fever of unknown origin （ FUO）. Methods The clinical data of 126 cases of FUO admitted to the Xinqiao Hospital from February 2000 to October 2007 were analyzed. Results The classic FUO induced by mainly the infective diseases （ 50.79% , 64/126） including tuberculosis infection （31.25% , 20/64） in it; malignant tumor （24.6%, 31/126） ; connective tissue diseases （15.87% , 20/126） , the other diseases （3.17%, 4/126） and unknown diseases （5.56% , 7/126）. Conclusion The main diseases in the infective, connective tissue and malignant tumor diseases were tuberculosis infection, adult Stillg disease and lympboma, respectively. The diagnostic method of FUO should be systemic and sequential and the bacterial culture, ultrasound and CT examination were done in time. The repeated puncture, biopsy and traumatic examination are helpful to clinical diagnosis.