不明原因发热患者的诊断与病因分析

目的分析不明原因发热(FUO)患者诊断方法的选择和病因的确定。方法回顾性分析362例FUO患者的诊断方法和病因。结果316例患者经过血清学、细菌学、体液检查、骨髓检查、组织活检、手术探查,并结合临床经过和试验治疗效果明确临床诊断。其中感染性疾病176例(包括细菌感染134例,病毒感染34例,真菌感染5例,其他3例),非感染性疾病140例(包括血管结缔组织病65例,肿瘤性疾病61例,其他疾病14例)。最后仍有46例患者诊断不明。结论对于FUO的诊断应该尽量获得病原学、免疫学和病理学的诊断依据,感染性疾病、血管结缔组织病和肿瘤性疾病是FUO发病的主要原因。

Analysis of the diagnostic methods and etiological factors in patients with fever of unknown origin

Objective To analyze the diagnostic methods and etiological factors in patients with fever of unknown origin (FUO).Methods The clinical data of 362 patients with FUO,who were treated in hospital since March 2001 to May 2005,were retrospectively analyzed.Results Among the 362 patients,316 patients were definitely diagnosed (87.3%).Among the 316 definite diagnosis patients,176 cases were infectious disease,134cases were becterial infection (134 cases were virus infection,5 cases were fungus infection and 3 case belonged to other disese),140 cases were non-infections disease (65 cases were collagen vascular diseases,61 cases were malignant tumor and 14 cases belonged to other diseases).46 cases remained origin-unknown until they were discharged from hospital.Conclusion In the diagnosis of FUO,we should manage to collect pathogenic,immunologic and pathologic evidences.Infectious di-seases,collagen vascular diseases and malignant tumors are the main causes of FUO.