224例不明原因发热患者病因分析

摘要

Objective To explore the etiologies of fever of unknown origin(FUO)and methods for confirming di-agnosis in patients at a hospital,and provide reference for clinical diagnosis and treatment of FUO.Methods Pa-tients with FUO admitted to a hospital between January 2008 and July 2014 were performed clinical diagnosis with methods of serology,bacteriology,molecular biology,bone marrow aspiration,tissue biopsy,and diagnostic thera-py,the etiologies and final diagnosis of 224 patients were analyzed retrospectively.Results Of 224 FUO cases,189 (84.38%)eventually got confirmed diagnosis,35 (15.62%)were not confirmed.The percentage of infectious dis-eases,connective tissue diseases,malignant tumor,and other diseases were 50.45%,18.75%,9.82%,and 5.36%respectively.Among infectious diseases,the major pathogens were bacteria,followed by virus.The major connec-tive tissue diseases were systemic lupus erythematosus and polyarteritis nodosa;the main malignant tumor was he-matological tumor,lymphoma was the main form.Among 189 patients with confirmed diagnosis,30.16% and 24.34% were performed pathogenic and pathologic detection respectively,and 20.11% were performed the other (compre-hensive)methods.Conclusion Infectious diseases,connective tissue diseases,and tumor are major etiologies of FUO.%目的：了解某院不明原因发热（FUO）患者病因，及其明确诊断的方法，为临床诊断和治疗 FUO 提供参考。方法应用血清学、细菌学、分子生物学、骨髓穿刺、组织活检，以及诊断性治疗等方法，对该院2008年1月—2014年7月收治的 FUO 住院患者进行临床诊断，回顾性分析224例 FUO 患者病因和最终诊断。结果最终明确病因者189例，占84．38％；未明确者35例，占15．62％。其中感染性疾病、结缔组织病、恶性肿瘤、其他类疾病分别占50．45％、18．75％、9．82％、5．36％。在感染性疾病中，细菌为主要病原体，其次为病毒；结缔组织病以系统性红斑狼疮和结节性多动脉炎为主；恶性肿瘤以血液系统肿瘤为主，而淋巴瘤最常见。189例确诊患者采用病原学检查者占30．16％，病理学检查者占24．34％，其他方法（综合分析）占20．11％。结论感染性疾病、结缔组织病、肿瘤为 FUO 的主要病因。