病因不明发热患者致热原因分析

Causes of fever in patients with fever of unknown origin

目的探究发热原因和发热时机不明的发热患者的致热原因。方法选取2012年3月至2016年1月在我院治疗的14周岁以上的发热原因和发热时机不明的发热患者198例,对其发热病因进行分析。结果 198例发热原因不明的患者中感染病患者96例,占48.5%,肿瘤性疾病患者56例,占28.3%,结缔组织-血管性疾病患者39例,占19.7%,诊断不明患者7例,占3.5%;感染性疾病发热患者病因分布结果显示,普通细菌和病毒感染、肺结核、结核性脑膜炎、结核性脑脊髓膜炎、布氏杆菌感染、结核性胸膜炎、肝结核、伤寒患者分别占19.8%、15.6%、13.5%、11.5%、11.5%、10.4%、9.4%、8.3%;肿瘤性疾病发热患者病因分布结果显示,恶性组织细胞病、淋巴瘤、骨髓瘤、急性淋巴细胞性白血病、原发性肝癌患者分别占42.9%、21.4%、14.3%、10.7%、10.7%;结缔组织-血管性疾病患者病因分布结果显示,成人斯蒂尔氏病、系统性红斑狼疮、干燥综合征、坏死性血管炎、多发性肌炎、混合性结缔组织病、类风湿性关节炎患者分别占28.2%、23.1%、15.4%、12.8%、10.3%、5.1%、5.1%。结论大多数发热原因和发热时机不明的发热患者中,感染性疾病最多,其次是肿瘤性疾病。

Objective To analyze the causes of fever in patients with fever of unknown origin.Methods One hundred and ninety-eight patients with fever of unknown origin in our hospital from March 2012 to January 2016 were selected,and the causes of the disease were analyzed.Results Among the 198 cases,there were 96 cases of infection（accounting for 48.5%）,56 cases of neoplastic diseases（28.3%）,39 cases of connective tissue-vascular diseases（19.7%）,7cases of unclear diagnosis（3.5%）.Etiological analysis showed that the causes of fever in patients with infection included common bacteria and viral infection,pulmonary tuberculosis,tuberculous meningitis,cerebrospinal meningitis,Brucella infection,tuberculous pleurisy,hepatic tuberculosis,typhoid,accounting for 19.8%,15.6%,13.5%,11.5%,11.5%,10.4%,9.4%,8.3%,respectively.The causes of fever in patients with neoplastic diseases included malignant histiocytosis,lymphoma,myeloma,acute lymphocytic leukemia,and primary liver cancer,accounting for 42.9%,21.4%,14.3%,10.7%,10.7%,respectively.The causes of fever in patients with connective tissue-vascular diseases included adult onset Still＇s disease,systemic lupus erythematosus,Sjogren syndrome,necrotizing vasculitis,polymyositis,mixed connective tissue disease,rheumatoid arthritis,accounting for 28.2%,23.1%,15.4%,12.8%,10.3%,5.1%,5.1%,respectively.Conclusion Patients with fever of unknown origin are mostly caused by infectious diseases,followed by neoplastic diseases and connective tissue-vascular diseases.