Objective:To review the etiology in 4582 adult patients with fever of unknown origin(FUO) in Chinese literature from 1990 to 2013,and compare the differences between north and south areas and changes in different periods. Methods:Four thousand five hundred and eighty-two patients with FUO in 21 clinical research literatures from 1360 literatures searched from China National Knowledge Infrastructure( CNKI) database containing the key word "fever of unknown origin" from 1990 to 2013. The data were analyzed according to the difference between north and south areas,and changes in early period(1990 to 2003) and later period(2004 to 2013). Results:Among the 4582 FUO cases,the definite diagnosis was 90. 9%. The most common cause of FUO was the infectious disease(54. 4%),and the tuberculosis was more common(16. 2%). The patients with rheumatic autoimmune disease accounted for 15. 5%,adult Stillˊs disease (5. 6%) was more common. The tumor(more common in 4. 5% lymphoma),miscellaneous causes(more common in 3. 1% of drug-induced fever) and unknown reason accounted for 13. 2%,7. 8% and 9. 1%,respectively. The proportions of infectious disease and tumor in the South were significantly higher than those in the North(P<0. 01 and P<0. 05). The proportions of rheumatic autoimmune disease, drug-induced fever and miscellaneous causes in the South were lower than those in the North ( P <0. 01). The pathogeny proportions of the infectious disease,drug-induced fever and miscellaneous cause in early period of FUO were significantly lower than those in later period(P<0. 01),while the pathogeny proportions of the viral disease,tumor and miscellaneous cause in early period of FUO were significantly higher than those in later period (P<0. 01). Conclusions:The infectious disease is the most common cause of FUO. There are some differences in pathogeny constituent between north and south areas,which changes over time.%目的:分析1990-2013年中文文献报道的的4582例不明原因发热(FUO)患者病因构成,并比较南北地区的差异及不同时期的变化.方法:以"不明原因发热"为主题词,对1990-2013年中国知网收录的中文文献进行检索,得到文献1360篇,经筛选最终纳入21篇临床研究文献,共计4582例患者.按照文献报道地域分南、北方,按文献报道时期分为1990-2003年(早期)和2004-2013年(后期),并进行比较.结果:4582例患者确诊率为90.9%;病因构成依次为感染性疾病54.4%,以结核(16.2%)多见;风湿免疫病15.5%,以成人Still病(5.6%)多见;肿瘤13.2%,以淋巴瘤(4.5%)多见;其他病因7.8%,以药物热(3.1%)多见;不明原因9.1%.南方感染性疾病和恶性肿瘤构成比均高于北方(P<0.01和P<0.05),风湿免疫病、药物热、其他病因及不明原因构成比均明显低于北方(P<0.01).早期感染性疾病、药物热和其他疾病构成比均明显低于后期(P<0.01),而恶性肿瘤和不明原因发热构成比均显著高于后期(P<0.01).结论:我国FUO病因仍以感染性疾病为主,南、北方病因构成存在一定差异,随时间推移病因构成亦有所变化.
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