不明原因发热689例病因分析

目的探讨不明原因发热（FUO）的病因分布及临床特征。方法回顾性分析2000年1月—2007年12月在解放军总医院内科住院且符合FUO诊断标准的689例患者的病因、诊断方法、临床表现。结果 689例患者中确诊病例为633例,确诊率为91.9%。病因：感染性疾病269例（39.0%）,其中结核病所占比例最高达48.7%（131/269）,肺外结核并不少见;结缔组织病236例（34.3%）,其中成人斯蒂尔病所占比例最高达53.8%（127/236）;恶性肿瘤69例（10.0%）,其中淋巴瘤所占比例最高达56.5%（39/69）,所有肺癌均合并有阻塞性肺炎;其他疾病59例（8.3%）,其中克罗恩病所占比例最高达22.0%（13/59）;出院时仍未明确诊断疾病56例（8.1%）。结论感染性疾病仍然是FUO的主要病因,结核病所占比例最高,其次结缔组织病和恶性肿瘤在FUO中也占有相当比例,大多数FUO通过仔细检查和分析最终可明确诊断。

Clinical analysis of 689 cases with fever of unknown origin

Objective To investigate the causes and the clinical features of fever of unknown origin（FUO）. Methods Retrospectively analysed the clinical data of 689 cases with FUO,which were hospitalized in the PLA ge neral hospital from January 2000 to December 2007,included etiology,diagnosis,and clinical features.Results There were 633 cases of 689 FUO cases diagnosed clearly,which the diagnosis ratio was 91.9%.The etiology distribution of the FUO was：the infective diseases（269/689,39.0%）,connective tissue diseases（236/689,34.3%）, malignant tumor disease（69/689,10.0%）,the other diseases（59/689,8.3%） and unknown diseases（56/689, 8.1%）.The most common diseases in infective diseases,connective tissue disease,malignant tumor,and the other diseases included tuberculosis（131/269,48.7%）,AOSD（127/236,53.8%）,lymphoma（39/69,56.5%） and Crohn disease（13/59,22.0%） respectively.Conclusion The infective diseases was the most common reason in FUO cases still,and tuberculosis was the most familiar.In addition,the percentage of the connective tissue disease and malignant tumor disease with FUO was also high relatively.Most FUO cases could be diagnosed through careful examination and analysis.