[1979年至2012年成人不明原因发热患者病因分布的中文文献综述]

[Chinese literature review of etiology distribution of adult patients with fever of unknown origin from 1979 to 2012].

作者信息

Tan Xing-yu, He Quan-ying

机构信息

Email:

Pulmonary & Critical Care Medicine, People's Hospital, Peking University, Beijing 100044, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2013 Dec;52(12):1013-7.

PMID:24503397

Abstract

OBJECTIVE

To review the etiology of 10 201 adult patients with fever of unknown origin (FUO) in China from 1979 to 2012, and to compare the reasons between the South and the North of China, and to illustrate the change in different periods.

METHODS

Literatures containing key word "fever of unknown origin" were selected in China National Knowledge Infrastructure (CNKI) database from 1979 to 2012. Articles were excluded if patient population were less than 100. Diagnostic criteria of FUO were confirmed by the standard of Petersdorf and Beeson in 1961. Totally 43 literatures including 10 201 patients were enrolled in this study. The period of the literatures were divided into the early, middle and later period, and the regions were partitioned into the South and the North.

RESULTS

A total of 42 articles (including 9787 patients) provided the gender information with 5063 men and 4724 women. The etiologies of 10 201 FUO patients included infectious diseases (53.5%), rheumatic diseases (20.1%) and tumor (12.0%). The positive diagnostic rate was 91.8%. Tuberculosis (23.8%) was the most common reason in infectious diseases. Adult Still's disease (7.0%) was the most common cause of FUO among rheumatic diseases. Lymphoma (3.4%) was the most common tumor in FUO patients. Besides, drug-induced fever (1.7%) should also be considered. In the recent 30 years, the proportion of FUO caused by infectious diseases had decreased, rheumatic diseases and other reason had increased (P < 0.05). The proportion of tumor in middle period was significantly higher than that in the early and later period (P < 0.05). The negative diagnostic rate had increased (all P < 0.05). The proportion of infectious diseases in North China was significantly lower than that in the South (P < 0.05). The proportion of other reason was significantly higher in the North (P < 0.05).

CONCLUSION

In the recent 30 years, the most common cause of FUO was still infectious diseases, especially tuberculosis.

摘要

目的

回顾1979年至2012年中国10201例不明原因发热（FUO）成年患者的病因，比较中国南方和北方的病因差异，并阐述不同时期的变化情况。

方法

在中国知网（CNKI）数据库中选取1979年至2012年包含关键词“不明原因发热”的文献。若患者人数少于100例则排除该文章。采用1961年彼得斯多夫和比森的标准确认FUO的诊断标准。本研究共纳入43篇文献，包含10201例患者。将文献发表时期分为早期、中期和后期，地区分为南方和北方。

结果

共有42篇文章（包括9787例患者）提供了性别信息，其中男性5063例，女性4724例。10201例FUO患者的病因包括感染性疾病（53.5%）、风湿性疾病（20.1%）和肿瘤（12.0%）。阳性诊断率为91.8%。结核病（23.8%）是感染性疾病中最常见的原因。成人斯蒂尔病（7.0%）是风湿性疾病中FUO最常见的病因。淋巴瘤（3.4%）是FUO患者中最常见的肿瘤。此外，药物热（1.7%）也应予以考虑。近30年来，感染性疾病所致FUO的比例下降，风湿性疾病及其他原因所致比例上升（P<0.05）。中期肿瘤的比例显著高于早期和后期（P<0.05）。阴性诊断率上升（均P<0.05）。华北地区感染性疾病的比例显著低于南方（P<0.05）。其他原因的比例在北方显著更高（P<0.05）。