| Objectives 1.To analyze the distribution of the cause of fever of unknown cause and the clinical features of various causes,so as to provide an idea for the exploration of a more efficient FUO diagnostic scheme.2.To investigate the three inflammatory indices of calcitonin,erythrocyte sedimentation and leukocyte count for patients with fever of unknown origin,the early differentiation of the disease because of the infectious and non infectious factors,and to provide the basis for the clinical application of antibiotics.Methods 1.The patients admitted to the hospital from January 2016 to July and eligible for the diagnostic criteria of fever of unknown origin were included in the diagnostic process adopted in this study to evaluate the diagnostic efficiency of the diagnostic process.According to the final etiological diagnosis,the patients were divided into infection group,connective tissue disease group,tumor group,miscellaneous disease group and undiagnosed group,and the distribution and clinical characteristics of all the above causes were analyzed.2.In the study,the patients who met the definitive diagnosis and did not receive antibiotics before the first week of the study were enrolled in the study.The laboratory data of procalcitonin,erythrocyte sedimentation rate,white blood cell count and so on for the first time within 24 hours after admission were collected.According to their final diagnosis,they were divided into infection group and non infection group.The clinical value of these inflammatory markers in the diagnosis of fever of unknown origin was evaluated.Results 1.The average diagnostic rate of the diagnostic protocol used in this study is 88.10%.The average rate of diagnosis in the past 5 years reported by CNKI is 87.82%.In the etiological classification of FUO,the largest proportion of infectious diseases was 60.71%(52 persons),and connective tissue disease ranked the second in 11.90%(10 people).The proportion of tumor diseases was 7.14%(6 persons),and the other reasons group reached 8.33%(7 persons),and the undiagnosed group was 11.90%(10 persons).In the application of the diagnosis scheme,other disease groups need confirmed the longest,followed by connective tissue disease group,infection group confirmed it is the shortest time;connective tissue disease caused by FUO with the longest average hospitalization days,hospitalization time is not the shortest diagnosis group.2.When WBC>9.5×10^9/L,PCT>0.5ng/ml positive standard infection group was significantly higher than non infected group,when ESR>50mm/h as positive standard non infection group was significantly higher than those in the infection group,WBC,ESR and PCT in the diagnosis of infectious diseases caused by the sensitivity of FUO were 50%,54.2%,93.8%;the specificity was 89.5%,31.6%,47.4%;-0.142,0.395,Youden index was 0.412;the area under the ROC curve was 0.752,0.580,0.698.Conclusions 1.The most common cause of FUO was infectious diseases,and connective tissue disease ranked second.The FUO diagnostic protocol used in this study is the shortest in the diagnosis of FUO caused by infectious diseases,and is superior to the diagnosis of FUO caused by other etiologies.2.This study shows that three classic inflammatory markers,WBC,ESR and PCT have certain differential diagnostic value in identifying FUO patients caused by infectious diseases.They can be used for early diagnosis of FUO,and provide a basis for early clinical application of antibiotics. |
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