CAJ | 학술논문

目的：探讨不明原因发热（ fever of unknown origin ， FUO）的病因分布及临床特点，减少误诊率。方法回顾性分析2008年1月-2011年10月于大连医科大学附属第二医院血液科住院的90例FUO患者的临床资料，包括病史、症状、体征，实验室检查，影像学检查及病理检查。采用独立样本t检验，比较不同病因相关生化指标的差异。结果90例患者中81例确诊，确诊率90％。病因包括：感染性疾病43例占53．1％，其中结核14例，占感染性疾病首位；恶性肿瘤10例占12．3％，其中非霍奇金淋巴瘤5例，血管免疫母细胞性T细胞淋巴瘤4例；结缔组织病10例占12．3％，其中成人Still’s病5例占50％；其他疾病18例占22．2％，其中噬血细胞性淋巴组织细胞增生症（hemophagocytic lymphohistiocytosis ，HLH）11例，占61．11％；未确诊病例9例占9％。结论感染性疾病是本组FUO患者的主要病因，其中结核所占比例最高。此外噬血细胞性淋巴组织细胞增生症，非霍奇金淋巴瘤也常见。
목적：탐토불명원인발열（ fever of unknown origin ， FUO）적병인분포급림상특점，감소오진솔。방법회고성분석2008년1월-2011년10월우대련의과대학부속제이의원혈액과주원적90례FUO환자적림상자료，포괄병사、증상、체정，실험실검사，영상학검사급병리검사。채용독립양본t검험，비교불동병인상관생화지표적차이。결과90례환자중81례학진，학진솔90％。병인포괄：감염성질병43례점53．1％，기중결핵14례，점감염성질병수위；악성종류10례점12．3％，기중비곽기금림파류5례，혈관면역모세포성T세포림파류4례；결체조직병10례점12．3％，기중성인Still’s병5례점50％；기타질병18례점22．2％，기중서혈세포성림파조직세포증생증（hemophagocytic lymphohistiocytosis ，HLH）11례，점61．11％；미학진병례9례점9％。결론감염성질병시본조FUO환자적주요병인，기중결핵소점비례최고。차외서혈세포성림파조직세포증생증，비곽기금림파류야상견。
Objective To investigate the etiololgic classification and clinical characteristics of Fever of Unknown Origin (FUO) in 90 patients.Methods Ninety patients with FUO were diagnosed in the Second Affiliated Hospital of Dalian Medi-cal University from January 2008 to October 2011 .The clinical data included clinical manifestations , laboratory tests , ima-ging examinations and pathological examination .Results Among the 90 FUO cases, definite diagnosis was eventually a-chieved in 81 patients(90%).Infectious diseases (n=43, 53.1%) were the most common causes of FUO .Tuberculosis (n=14) accounted for 32.56%of all the infectious causes.Neoplasm was found in 10 (12.3%) patients, Angioimmuno-blastic T-Cell Lymphoma(n=4) were mostly associated with FUO among neoplasms .Ten patients were suffered from col-lagen vascular diseases:with adult Still's disease ( n=5 ) accounting for 50%.Miscellaneous diseases were found in 18 (22.2%) patients, hemophagocytic lymphohistiocytosis ( n=11) were mostly associated with FUO among Miscellaneous diseases .Conclusion Infectious diseases , especially tuberculosis , were the leading diagnostic category of FUO in this stud-y.Hemophagocytic lymphohistiocytosis and Angioimmunoblastic T -Cell Lymphoma were more common than others .