不明原因发热与普通发热待查的回顾性比较分析

目的回顾性比较不明原因发热(FUO)与普通发热待查病人病因分布、住院时间、住院花费。方法回顾性比较不明原因发热病人372例和普通发热待查的病人780例。结果 FUO组372例中确诊率为90.3%,病因构成为感染病226例(60.8%),结核病75例(33.2%),风湿免疫病48例(12.9%),肿瘤31例(8.3%),其它33例(8.9%);出院时仍未确诊的36例(9.7%)。普通发热待查组780例中确诊率为98.8%,病因构成为感染病717例(91.9%),风湿免疫病15例(1.9%),肿瘤9例(1.2%);出院时仍未确诊的9例(1.2%)。两组病因构成差异有统计学意义(χ2=178.23,P=0.000)。FUO组住院天数(15±12天)长于普通发热待查组(12±9天)(Z=-5.739,P0.05)。FUO组住院花费(13813.84±14720.62元)显著高于普通发热待查组(7014.20±7517.11元)(Z=-7.971,P0.05)。结论感染性疾病是FUO与普通发热待查的主要病因,普通发热待查组感染性疾病所占比率更高,FUO组中风湿免疫病及肿瘤占有相当大的比率。FUO组的住院时间更长、住院花费更大。

A retrospective study on fever of unknown origin and the distribution of causes of common fever

Objective To explore the difference in distribution of pathogenic causes,duration of hospitalization and cost for hospitalization between patients with fever of unknown origin and common febrile diseases. Methods The clinical data of 372 patients with FUO were retrospec-tively compared with the clinical data of 780 patients with common fever. Results The diagnostic rate of 372 cases in FUO group was 90. 3% ,the etiologic causes of 226 cases were infection（60. 8% ）including 75 cases of tuberculosis（33. 2% ）,48 cases of rheumatism（12. 9% ）,31 cases of tumor（8. 3% ）,33 cases with other causes（8. 9% ）,and there were 36 cases（9. 7% ）still unknown at discharge from the hospital. In ordi-nary fever group of 780 cases,the diagnostic rate was 98. 8% ,the etiologic causes of 717 cases were infection（91. 9% ）,rheumatism in 15 cases （1. 9% ）,tumor in 9 cases（1. 2% ）,and there were 9 cases（1. 2% ）still unknown at discharge from the hospital. There was significant differ-ence（χ2 = 178. 23,P = 0. 000）in etiology between these 2 groups. In group FUO,days of hospitalization（15 ± 12 days）were longer than those of common fever group（12 ± 9 d）（ Z = - 5. 739,P 〈 0. 05）. The average cost of FUO group was 13 813. 84 ± 14 720. 62 yuans,and it was significantly higher than that of ordinary fever group（7 014. 20 ± 7517. 11 yuans）（Z = - 7. 971,P 〈 0. 05）. Conclusion Infectious diseases are the major causes of FUO and ordinary fever group,and the incidence rate of infection in ordinary group is higher than that of FUO group. Rheumatism and tumor have quite large proportion in FUO group. Patients in FUO group have longer duration of hospitalization and more cost than those of patients in common febrile group.