429例不明原因发热患者的病因组成及诊断Clinical Analysis of 429 Cases of Fever of Unknown Origin
高恺言,邹耀红,袁风红,陈海凤,邹敏超
GAO Kaiyan,ZOU Yaohong,YUAN Fenghong,CHENG Haifeng,ZOU Mingchao
摘要(Abstract):
目的:分析429例不明原因发热(FUO)患者的病因及确诊方式。方法:收集以FUO收治住院的429例患者临床资料、分析最后诊断、确诊方式及发热病因构成。结果:429例中有321例符合FUO诊断标准,321例中有307例最终明确诊断,确诊率95.64%;感染性疾病引起的发热125例(40.7%),结缔组织病引起的发热130例(42.3%),肿瘤引起的发热29例(9.4%),其它疾病23例(7.5%);108例不符合FUO诊断标准,其中有104例最终明确诊断,确诊率96.3%;感染性疾病引起的发热80例(76.9%),结缔组织病引起的发热15例(14.4%),肿瘤引起的发热5例(4.8%),其它疾病引起的发热4例(3.8%)。结论:结缔组织病和感染性疾病是FUO主要原因,感染性疾病和结缔组织病是非FUO的主要原因。
Objective: To determine the causes for fever of unknown origin( FUO) and improve the accuracy of diagnosis for FUO. Methods: The characteristics,diagnostic methods and etiologies of 429 patients with FUO were retrospectively collected and analyzed in our department during the period from July 2011 to June 2016. Results: 321 out of 429 patients reached the criteria for FUO. 307 patients( 95. 6%) were definitely diagnosed. Connective tissue diseases were the cause for fever in 130 cases( 42. 3%),followed by infections in 125 cases( 40. 7%). Neoplasms in 29( 9. 4%) and other diseases in 23( 7. 5%). 104 cases( 96. 3%) were finally diagnosed out of 108 patients that did not reach the criteria for FUO,in which infections were the cause in 80 cases( 76. 9%),followed by connective tissue diseases in 15 cases( 14. 4%),neoplasms in 5( 4. 8%) and other diseases in 4 cases( 3. 8%). Conclusion: Connective tissue diseases were the leading cause for FUO,followed by infections and neoplasms,while infections were the main cause of fever,followed by connective tissue diseases and neoplasms in non-FUO patients.
关键词(KeyWords):
发热,不明原因;混合性结缔组织病;感染;肿瘤;早期诊断
fever,unknown origin;connective tissue diseases;infections;neoplasms;early diagnosis
基金项目(Foundation):
作者(Author):
高恺言,邹耀红,袁风红,陈海凤,邹敏超
GAO Kaiyan,ZOU Yaohong,YUAN Fenghong,CHENG Haifeng,ZOU Mingchao
DOI: 10.19367/j.cnki.1000-2707.2017.10.028
参考文献(References):
- [1]缪晓辉.不明原因发热病因诊断经验谈[J].中华医学杂志,2006(42):2959-2961.
- [2]Petersdorf RG,Bee son PB.Fever of unexplained origin:report on 100 Cases[J].Medicine,2011(1):1-30.
- [3]徐蒙,马安林,袁立超.发热待查1854例临床分析[J].中华实验和临床感染病杂志(电子版),2009(4):36-38.
- [4]Vanderschueren S,Del Biondo E,Ruttens D,et al.Inflammation of unknown origin versus fever of unknown origin:two of a kind[J].Eur J Intern Med,2009(4):415-418.
- [5]翁心华,陈澍.原因不明发热的病因诊断与合理治疗[J].中华内科杂志,2013(4):269-270.
- [6]Mourad O,Palda V,Detsky AS.A comprehensive evidencebased approach to fever of unknown origin[J].Arch Inter Med,2013(5):545-551.
- [7]Knoekaert DC,Vanderschueren S,Blockmans D.Fever of unknown origin in adults:40 years on[J].J Intern Med,2003(3):263-275.
- [8]周建明.不明热的诊断[J].日本医学介绍,2002(4):180-180.
- [9]孙洪良,谢文秀,马航航,等.成人Still病26例误诊原因分析[J].临床误诊误治,2015(7):25-27.
- [10]连帆,杨岫岩,梁柳琴,等.血清铁蛋白水平对成人斯蒂尔病诊断的临床价值[J].中华风湿病学杂志,2005(6):338-341.
- [11]Solans-Laque R,Bosch-Gil JA,Perez-Bocanegra C,et al.Paraneoplastic vasculitis in patients with solid tumors:report of 15 cases[J].Rheumatnlogy,2008(2):294-304.
- [12]Hutson TE,Hoffman GS.Temporal concurrence of vasculitis and cancer:a report of 12 cases[J].Arthritis Care Res.2010(6):417-423.
- [13]施宏莹,赵丽丹,徐东,等.恶性肿瘤模拟血管炎24例临床分析[J].中华风湿病学杂志,2015,19(8):534-539.
- [14]谭星宇,何权瀛.1979-2012年中文文献报道的成人不明原因发热病因构成分布[J].中华内科杂志,2013(12):1013-1017.
- [15]马小军,王爱霞,邓国华,等.不明原因发热449例临床分析[J].中华内科杂志,2014(9):682-685.
- [16]石秋萍,王超,徐定华,等.不明原因发热372例临床分析[J].中华内科杂志,2014(4):298-302.
- [17]涂俊才,周平,李晓娟,等.500例不明原因发热患者临床病因分析[J].中国医学科学院学报,2015(3):348-351.
- [18]马先明,杜鹃,马文,等.发热待查53例临床分析[J].贵阳医学院学报,2012(4):438-439.
文章评论(Comment):
|
||||||||||||||||||
|
- 发热,不明原因
- 混合性结缔组织病
- 感染
- 肿瘤
- 早期诊断
fever,unknown origin - connective tissue diseases
- infections
- neoplasms
- early diagnosis