发热待查疾病谱及变迁

Spectrum and changes offever of unknown origin

发热是许多疾病常见的临床表现,也是患者就诊的常见原因之一。但是很多发热患者的病因诊断却非常困难,有时甚至无法找到确切病因。发热待查也称为不明原因发热(feverofunkownorigin,FUO),是指持续发热在3周以上,多次检测体温在38.3℃以上,且有1周以上的根据病史、体格检查和常规实验室检查仍然不能明确病因的疾病。发热待查概念的提出为不明原因发热患者的诊治提供了重要的临床思路。近年来随着医疗技术的进步和流行病学的变迁使得发热性疾病的疾病谱也有了相应的变化。为了探讨总结发热待查的病种组成,疾病谱的分布及变迁趋势,为临床诊断提供参考思路。

Fever is a common clinical manifestation of many diseases and is one of the common reasons for patients to see a doctor. However, the diagnosis of the cause of fever in many patients is very difficult, sometimes even unable to find the exact cause. Fever is also known as fever of unkown origin (FUO), It was defined FUO as body temperatureabove 38.3°C on three or more occasions and a duration of illness of at least three weeks, in which no diagnosis was made after one week of hospital admission or physical examination and routine laboratory examination. The concept of fever to be investigated provides an important clinical idea for the diagnosis and treatment of patients with unexplained fever. In recent years, with the progress of medical technology and the change of epidemiology, the spectrum of febrile diseases has changed correspondingly. This article aims to discuss and summarize the composition of fever, distribution and change trend of disease spectrum, and provide a reference for clinical diagnosis.