■不明原因发烧(FUO)长期以来一直是临床医生关注的问题,它的光谱随着医学的进步而发展。本研究旨在调查2013年至2022年中国FUO的病因分布,以促进临床对FUO病因的认识。
■2013年至2022年期间发布的中国FUO案例系列从PubMed检索,万方数据,和CNKI数据库进行回顾性分析。计算了FUO的不同原因的比率,并将这些数据与以前发表的中国FUO病因分布进行了比较。
■在51个确定的病例系列(n=19,874)中,FUO发病率最高的原因是传染性的,自身免疫,和肿瘤性疾病(59.6%,14.3%,和7.9%,分别)。一个子集的比较(按疾病类别细分的43例病例系列,n=16,278),先前报告的数据显示,在过去十年中,归因于传染病的FUO比率增加,血液感染的发生率明显更高(10.0%vs.4.8%)和显著较低的结核病发病率(9.3%vs.28.4%),与上一期的费率相比。相比之下,归因于自身免疫性疾病和肿瘤性疾病的FUO发病率下降,在自身免疫性疾病中,成人发作的斯蒂尔病发病率显著下降(4.6%与8.5%)和肺癌在肿瘤疾病中(0.6%与1.6%)。
■尽管传染病导致的发病率总体上升,结核病的发病率有所下降。自身免疫性疾病和肿瘤性疾病的发病率也有所下降。
UNASSIGNED: Fever of unknown origin (FUO) has long been a cause for concern among clinicians, and its spectrum has evolved with progress in medicine. This study aimed to investigate the distribution of causes of FUO in China between 2013 and 2022 to facilitate the clinical understanding of the etiology of FUO.
UNASSIGNED: Case series of FUO in China published between 2013 and 2022 were retrieved from PubMed, Wanfang Data, and CNKI databases and retrospectively analyzed. The rates of different causes of FUO were calculated, and these data were compared with previously published distributions of causes of FUO in China.
UNASSIGNED: The causes of FUO with the highest rates from the 51 identified case series (n = 19,874) were infectious, autoimmune, and neoplastic diseases (59.6%, 14.3%, and 7.9%, respectively). A comparison of a subset (43 case series subdivided by disease category, n = 16,278) with previously reported data revealed an increased rate of FUO attributed to infectious diseases in the past decade, with a significantly higher rate attributed to bloodstream infections (10.0% vs. 4.8%) and a significantly lower rate attributed to tuberculosis (9.3% vs. 28.4%), compared with the rates from the previous period. In contrast, the rates of FUO attributed to both autoimmune and neoplastic diseases decreased, with significantly decreased rates attributed to adult-onset Still\'s disease among autoimmune diseases (4.6% vs. 8.5%) and lung cancer among neoplastic diseases (0.6% vs. 1.6%).
UNASSIGNED: Despite an overall increase in the rate attributed to infectious diseases, that attributed to tuberculosis has decreased. The rates attributed to both autoimmune and neoplastic diseases have also decreased.