CAJ | 학술논문

目的：为提高不明原因发热（ fever of unknown origin，FUO）诊断的准确性，探讨其规律，回顾性研究我院风湿免疫科住院的192例FUO患者的临床特点，分析其病因，总结治疗经验，形成合理的诊疗思路，指导临床工作。方法本研究选取2011年5月1日-2013年11月30日在风湿免疫科住院（包括转入患者）且符合1999年我国学者提出FUO诊断标准的患者192例，复习相关病历资料，总结发病特点和直接确诊指标。结果192例FUO患者最终169例患者确诊，确诊率为88.02%。主要疾病依次是：结缔组织和血管炎性疾病（61.46%）、感染性疾病（22.40%）、恶性肿瘤性疾病（2.08%）、其他疾病（2.08%），其中未明确原因的疾病占11.98%。导致FUO的主要病种为系统性红斑狼疮、成人Still病、风湿性多肌痛、干燥综合征、感染（细菌、EB病毒、结核）、肿瘤等。169例确诊患者中女性较男性比例高，且在免疫系统疾病组中女性患者明显高于男性；老年人FUO中恶性肿瘤常见。结论随着风湿病知识的普及和专科大夫的增多，不典型风湿病诊断率明显提高。本研究总结了FUO的病例特点、病因及化验检查等，形成一定合理性的诊疗思路，不断提高不明原因发热疾病诊断的准确性。
목적：위제고불명원인발열（ fever of unknown origin，FUO）진단적준학성，탐토기규률，회고성연구아원풍습면역과주원적192례FUO환자적림상특점，분석기병인，총결치료경험，형성합리적진료사로，지도림상공작。방법본연구선취2011년5월1일-2013년11월30일재풍습면역과주원（포괄전입환자）차부합1999년아국학자제출FUO진단표준적환자192례，복습상관병력자료，총결발병특점화직접학진지표。결과192례FUO환자최종169례환자학진，학진솔위88.02%。주요질병의차시：결체조직화혈관염성질병（61.46%）、감염성질병（22.40%）、악성종류성질병（2.08%）、기타질병（2.08%），기중미명학원인적질병점11.98%。도치FUO적주요병충위계통성홍반랑창、성인Still병、풍습성다기통、간조종합정、감염（세균、EB병독、결핵）、종류등。169례학진환자중녀성교남성비례고，차재면역계통질병조중녀성환자명현고우남성；노년인FUO중악성종류상견。결론수착풍습병지식적보급화전과대부적증다，불전형풍습병진단솔명현제고。본연구총결료FUO적병례특점、병인급화험검사등，형성일정합이성적진료사로，불단제고불명원인발열질병진단적준학성。
Objective:To improve the accuracy of diagnosis of FUO,investigate the regularity. This study retrospective-ly analyzed 192 patients with FUO patient′s distribution of proportion and their characteristics,and analysis the FUO with the same or similar clinical symptoms or signs of FUO of common diseases to summary the experience and therapeutic expe-rience and to guide clinical diagnosis and treatment. Methods:192 cases of FUO were chosen from the patients in the De-partment of Rheumatology in The Central Hospital of Taian from January 2011 to December 2013. The patients′information was collected and analyzed. Results:169 cases were confirmed among 192 hospitalized patients with FUO. The main cau-ses of FUO in this study were:connective tissue diseases and vasculitis(61. 46%),infectious diseases(22. 40%),malig-nant tumor(2. 08%)and other diseases(2. 08%). The unidentified cases in this study accounted for 11. 98% . The dis-eases that caused FUO in this study contained systemic lupus erythematosus,adult Still′s disease,polymyalgia rheumatica, Sjogren′s syndrome and infective disease,ect. Among the 169 diagnosed patients,women accounted for a higher proportion than men,especialy in the connective tissue diseases group,while the older were more likely to have malignant tumor than others. Conclusion:The clinical characteristics of FUO cases are summarized in this study to improve the diagnostic accura-cy of FUO and to provide a rational strategy to guide clinical practice.