不明原因长期发热110例临床分析

A clinical analysis of 110 cases with fever of unknown origin

目的探讨我国不明原因长期发热的病因。方法回顾性地总结分析１９９５年１月至１９９６年１２月间在我科住院且符合不明原因长期发热（ＦＵＯ）诊断标准的患者１１０例。结果１１０例患者经各种检查或特异性治疗最后明确诊断者有１０２例，确诊率为９２７％。病因：感染性疾病５８例，占５２７％，其中结核病２７例，占感染性疾病的４６６％（２７／５８）；自身免疫性疾病２１例，占１９１％，Ｓｔｉｌ病占自身免疫性疾病的４２９％（９／２１）；肿瘤性疾病７例，占６４％；其他疾病１６例，占１４５％；原因仍未明者８例，占７３％。结论感染性疾病仍然是ＦＵＯ的主要病因，结核病尤其是肺外结核的发病率有增高趋势，本组肺外结核占３１０％（１８／５８）；其次自身免疫性疾病和肿瘤性疾病在ＦＵＯ中也占有相当比例，Ｓｔｉｌ病和不典型淋巴瘤诊断比较困难。

Objective To investigate the cause of fever of unknown origin (FUO). Methods The clinical data of 110 patients with FUO admitted to Peking Union Medical College Hospital from January 1995 to December 1996 were analyzed. Among them 44 were males and 66 females with an average age of 36 years, ranging from 13 and 71. Results After various examinations and specific treatment the definite diagnosis was finally made in 102 cases. Among them 58 cases (52.7%) were caused by infections with 27 by tuberculosis; 21 cases (19.1%) were due to autoimmune diseases, with 9 being Still's disease; 7 cases (6.4%) were due to tumors, 16 cases (14.5%) were due to other diseases and in 8 cases (7.3%) the cause was still unknown after hospitalization. Conclusion Infection is the main cause of FUO, the incidence of tuberculosis was the highest among the various infectious diseases as the cause of FUO and patients with extrapulmonary tuberculosis presented more frequently with FUO than those with intrapulmonary tuberculosis. Still's disease and lymphoma were the commonest causes of FUO in autoimmune diseases and malignant tumors respectively. Most of the patients with FUO were diagnosed finally with various examinations and careful analysis.