Clinical analysis of 215 consecutive cases with fever of unknown origin
Clinical analysis of 215 consecutive cases with fever of unknown origin
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发表时间：
2018
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通讯作者：
Y. Zhai;Xin Chen;Xin Liu;Zhi-qiang Zhang;H. Xiao;Gang Liu
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作者：
Y. Zhai;Xin Chen;Xin Liu;Zhi-qiang Zhang;H. Xiao;Gang Liu
不明原因发热（FUO）是临床上常见的现象。本研究的目的是探讨FUO的潜在原因，从而提高临床诊断这种疾病。在这项回顾性研究中，收集了2009年1月至2010年12月期间诊断为FUO的215例患者的临床数据，并对这些患者进行了18至36个月的随访。在这些FUO病例中，最常见的病因是感染性疾病（ID）（42.3%），其次是结缔组织疾病（CTD）（32.1%），杂项（Mi）（10.7%）和肿瘤（N）（6.5%），其余18例（8.4%）的病因尚不清楚。最常见的ID、CTD和N类型分别为结核（16/91，17.6%）、成人斯蒂尔病（AOSD）（37/69，53.6%）和非霍奇金淋巴瘤（6/14，42.9%）。ID仍然是FUO的最常见原因。规律性间歇发热伴泌尿系感染和不规律性间歇发热伴感染性心内膜炎可作为临床诊断FUO的一些征象。缩略语：95% CI = 95%置信区间，ALT =丙氨酸转氨酶，AOSD =成人斯蒂尔病，AST =天冬氨酸转氨酶，AUC =受试者工作特征曲线，CMV =巨细胞病毒，CRP = C反应蛋白，CT =计算机断层扫描，CTD =结缔组织病，EB = EB，ESR =红细胞沉降率，FUO =不明原因发热，HB =血红蛋白，HIV =人类免疫缺陷病毒，ID =感染性疾病，LDH =乳酸氢化酶，Mi =其他，N =肿瘤，PCT =降钙素原，PLT =致敏淋巴细胞试验，U =未诊断。
Fever of unknown origin (FUO) is a frequently observed phenomenon in clinical practice. The present study was aimed to investigate potential causes of FUO, thereby improving clinical diagnosis of this disorder. In this retrospective study, clinical data were collected from 215 patients who were diagnosed with FUO between January 2009 and December 2010, and an 18 to 36 months follow-up visit was also performed for these patients. Among these FUO cases, the most common causes of the disease were infectious diseases (IDs) (42.3%), followed by connective tissue diseases (CTDs) (32.1%), miscellaneous (Mi) (10.7%) and neoplasm (N) (6.5%), while the causes for the other 18 cases (8.4%) were still unknown. The most common types of ID, CTD, and N were tuberculosis (16/91, 17.6%), adult onset Still disease (AOSD) (37/69, 53.6%) and non-Hodgkin lymphoma (6/14, 42.9%), respectively. IDs still represent the most common causes of FUO. Regularly intermittent fever with urinary infections and irregularly intermittent fever with infective endocarditis may be regarded as some signs in clinical diagnosis of FUO. Abbreviations: 95% CIs = 95% confidence intervals, ALT = alanine aminotransferase, AOSD = adult onset Still disease, AST = aspartate transaminase, AUC = receiver-operating characteristic curve, CMV = cytomegalovirus, CRP = C-reactive protein, CT = computed tomography, CTDs = connective tissue diseases, EB = Epstein–Barr, ESR = erythrocyte sedimentation rate, FUO = fever of unknown origin, HB = hemoglobin, HIV = human immunodeficiency virus, IDs = infectious diseases, LDH = lactate hydrogenase, Mi = miscellaneous, N = neoplasm, PCT = procalcitonin, PLT = primed lymphocyte test, U = undiagnosed.