老年不明原因发热的临床分析

Clinical analysis of older patients with fever of unknown origin

目的分析老年不明原因发热患者的病因、临床特点及规律,为临床诊治提供参考。方法回顾性分析本院2008年1月-2010年12月104例不明原因发热患者在年龄、性别、发热持续时间、白细胞计数、病因分布规律、预后等方面的差异,了解老年不明原因发热临床特点。结果 104例患者,确诊率为89.3%,病死率为8.0%。按病因分为感染性疾病（52.0%）、肿瘤性疾病（6.7%）、免疫性疾病（18.3%）、其他（7.7%）及诊断不明性疾病（15.4%）。发热热程在1个月内的患者占63.5%,其中,感染性疾病占1个月内发热患者的81.5%。白细胞减少的病例26例,以免疫性疾病、肿瘤性疾病多见。结论感染是老年不明原因发热最主要的发病因素,老年不明原因发热患者有自身的病因分布规律及特点。

Objective To investigate the causes and clinical feature of older patients with fever of unknown origin（FUO）.Methods The clinical data of 104 cases of adult patients with FUO in our hospital from January 2008 to December 2010 were analyzed retrospectively.The age,sex,fever duration,leukocyte count,etiological factor distribution law and prognosis of patients were included in the study and the clinical features of older patients with FUO were analyzed.Results Among 104 cases of patients,the diagnosis rate was 89.3%,and the mortality rate was 8.0%.There were five classification of the causes of FUO,such as infectious disease（52.0%）,neoplastic disease（6.7%）,immunologic disease（18.3%）,miscellaneous disease（7.7%） and undetermined diagnosis disease（15.4%）.Patients with fever duration within one month were accounted for 63.5%,of whom patients with infectious disease were accounted for 81.5%.26 patients with immunologic disease and neoplastic disease suffered with leucopenia.Conclusion Infection is the most primary cause for older patients with FUO.FUO in older patients has its own pathogen distribution laws and clinical features.