不明原因发热临床分析328例

A Clinical Review of 328 Cases with Fever of Unknown Origin

目的探讨不明原因发热(FUO)的原因。方法回顾性分析2002年12月至2008年12月间在淄博市中心医院住院诊治符合的不明原因发热诊断标准的患者328例。结果 328例患者中经各种检查或诊断性治疗最终明确诊断是285例,确诊率86.9%。病因包括感染性疾病144例(50.8%),其中结核病62例(43.1%);结缔组织病99例(34.7%),其中系统性红斑狼疮占42.4%(42/99);Still病占15.4%(15/99),肿瘤性疾病30例(10.5%);其他疾病12例(4.0%),出院时仍未确诊的43例(13.1%)。结论感染性疾病是本组FUO患者主要病因,细菌感染是主要病种,结缔组织病和肿瘤性疾病在本组FUO病因中也占重要地位,大多数FUO经仔细的临床检查和分析是可以得到确诊的。

Objective To investigate the causes of fever of unknown origin（FUO） .Methods The clinical date in 328 patients with FUO were retrospectively analyzed who were hospitalized in the Central Hospital of Zibo from December 2002 to 2008.Results Out of 328 FUO cases,definite diagnosis was eventually achieved in 285 patients（86.9%） .The most causes of FUO were infectious disease（50.8%） ,with tuberculosis accounting for 43.1% of cases of infection.Ninety-nine patients were suffered from collagen vascular disease（CVD） ：with systemic lupus eythematosus and Still＇s disease for 42.4%（42/99） ,15.2%（15/99） of the this category.10.5%（30/285） of the FUO case were diagnosed as malignancy.Miscellaneous cause were found made in the remaining 43（13.1%） case until they dischargeed form the hospital.Conclusions In most FUO cases the cause can be diagnosed eventually after careful analysis of clinical date.While infectious diseases especially tuberculosis,were still the most common causes of FUO.CVD and malignancy were also major cause of FUO.The cause of FUO can be identifi ed by clinical symptoms,signs and laboratory examinations.