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目的探讨风湿免疫科不明原因发热(fever of unknown origin,FUO)住院患者的病因分布、临床特征及实验室特点。方法回顾性分析2000年1月至2010年1月我科收治的符合FUO诊断标准的483例患者的病因、诊断方法、临床特点以及实验室特点,并对出院时仍未诊断的进行随访。结果 483例中,男171例,女312例,年龄14～72岁,平均(36.5±13.4)岁。确诊459例,确诊率95%。风湿性疾病277例(57.3%),其中系统性红斑狼疮149例,成人斯蒂尔病60例;感染性疾病108例(22.3%),其中结核感染33例,均为肺外结核,败血症32例,主要为L型细菌感染;恶性肿瘤43例(8.4%),其中急性白血病13例;其他疾病31例(6.8%)。出院时仍未诊断疾病24例(5%)。发热时间超过1年的患者主要见于风湿性疾病。ESR≥100mm/h或CRP≥100mg/L的患者主要为风湿性疾病或感染性疾病或肿瘤。结论多数FUO的病因仍是常见病,风湿性疾病占FUO的比例逐渐增加,可能为其最主要的原因。
Objective To investigate the etiological distribution, clinical features and laboratory characteristics of inpatients with fever of unknown origin (FUO) in rheumatology department. Methods The etiology, diagnosis, clinical features and laboratory characteristics of 483 patients who met the FUO diagnostic criteria admitted to our department from January 2000 to January 2010 were analyzed retrospectively. The patients were followed up after discharge without diagnosis. Results Among 483 cases, 171 were male and 312 were female, aged from 14 to 72 years (mean, 36.5 ± 13.4 years). Confirmed 459 cases, the diagnosis rate of 95%. There were 277 cases (57.3%) of rheumatic diseases, including 149 systemic lupus erythematosus and 60 adult ones. 108 cases (22.3%) were infectious diseases, including 33 cases of tuberculosis infection, all of which were extrapulmonary tuberculosis and sepsis 32 Cases, mainly L-type bacterial infection; 43 cases of malignant tumors (8.4%), of which 13 cases of acute leukemia; other diseases in 31 cases (6.8%). Discharged still not diagnosed in 24 cases (5%). Patients who have been experiencing fever for more than 1 year are predominantly rheumatic. Patients with ESR> 100 mm / h or CRP> 100 mg / L are mainly rheumatic or infectious diseases or tumors. Conclusions Most of the causes of FUO are still common, and the proportion of rheumatic diseases in FUO gradually increases, which may be the most important reason.