结核菌感染在经典型不明原因发热诊断中的意义

Role of Tuberculosis Infection in the Fever of Unknown Origin with the Classic Type

目的探讨结核菌感染在经典型不明原因发热(FUO)诊断中的意义。方法对大型综合性医院497例经典型FUO患者中诊断结核菌感染的患者资料进行回顾性分析,并与国内相关文献报道的4784例患者资料进行对比分析。结果 (1)在经典型FUO患者中,感染性疾病是其最常见的原因(38.0%,189/497);明显低于文献组(51.9%,2484/4784),差异有统计学意义(χ2=34.77,P<0.001)。(2)本组中结核菌感染约占感染性疾病的51.8%(98/189),明显高于文献组(22.6%,562/2484),差异有统计学意义(χ2=82.35,P<0.001)。(3)在FUO相关的结核菌感染中,肺结核和结核性脑膜炎患者占所有结核菌感染的51.0%(50/98)。(4)有11.2%(11/98)的结核菌感染患者临床未发现结核病灶,抗结核治疗有效。结论结核菌感染在FUO病因分布中有一定的规律性,这对于结核菌感染的临床诊断、治疗有一定的指导意义。

Objective To probe into the role of tuberculosis （TB） infection in the fever of unknown origin （FUO） with the classical type.Methods We retrospectively analyzed the clinical data of 497 patients with fever of unknown origin with the classic type in a large hospital.TB infection was identified in all these 497 patients （FUO group）.The results were compared with the findings in 4 784 patients reported in Chinese literatures （literature group）.Results Infective diseases were common [38.0% （189/497）] in the FUO group,which was significantly lower than that in the leterature group （51.9%,2 484/4 784;χ2=34.77,P0.0001）.The rate of TB infection was 51.8% （98/189） among the infective diseases in the FUO group,which was significantly higher than that in the literature group （22.6%,562/2 484,χ2=82.35,P0.001）.About half of the patients（51.0%,50/98） in the FUO group with TB were pulmonary TB and tuberculous meningitis.Eleven patients （11/98,11.2%） in the FUO group responded well to anti-tuberculosis therapy,while no definite TB infection focus was noted.Conclusion TB infection has certain role among FUO etiologies.This finding may provide some guidance for the diagnosis and treatment of tuberculosis infection.