文章摘要
袁剑伟,王艳,李雅琴,等.发热伴淋巴结肿大初诊 163例病因及临床特征分析[J].安徽医药,2024,28(6):1197-1202.
发热伴淋巴结肿大初诊 163例病因及临床特征分析
Etiological distribution and clinical characteristics of 163 cases with fever combined with lymphadenopathy at first visit
  
DOI:10.3969/j.issn.1009-6469.2024.06.030
中文关键词: 发热  淋巴结肿大  病因  临床特征  传染病
英文关键词: Fever  Lymphadenopathy  Etiology  Clinical characteristics  Communicable diseases
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作者单位E-mail
袁剑伟 山西医科大学第三医院山西白求恩医院山西医学科学院同济山西医院感染病科山西太原 030032  
王艳 山西医科大学第三医院山西白求恩医院山西医学科学院同济山西医院感染病科山西太原 030032 sxbqeyywy@163.com 
李雅琴 山西医科大学第三医院山西白求恩医院山西医学科学院同济山西医院病理科山西太原 030032  
王琳 山西医科大学第三医院山西白求恩医院山西医学科学院同济山西医院感染病科山西太原 030032  
王宏霞 山西医科大学第三医院山西白求恩医院山西医学科学院同济山西医院感染病科山西太原 030032  
任圆 山西医科大学公共卫生学院山西太原030032  
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中文摘要:
      目的探讨以发热伴淋巴结肿大为特征疾病初诊病人的病因分布及临床特征,提高临床对该疾病的认知和诊断能力。方法收集 2020年 1月至 2022年 10月在山西白求恩医院初次收治的经淋巴结活检及病理检查诊断明确的 163例发热伴淋巴结肿大病人,根据病因分为感染性疾病组(感染组)、非感染性炎症性疾病组(非感染组)、肿瘤性疾病及造血系统疾病组(肿瘤及造血组)、其他类疾病组(其他组)对其性别、年龄、热程、淋巴结肿大特征、伴随症状、实验室资料、淋巴结病理等资料进行分析。结果 163例病人中,感染组 63例,(38.7%)、非感染组 32例( 19.6%)、肿瘤及造血组 31例( 19.0%)、其他组 37例( 22.7%)。临床特征中,四组间性别、年龄、淋巴结压痛、淋巴结肿大部位(头颈部 /胸部 /腹部)、合并全身性淋巴结肿大、半年内体质量下降≥10%均差异有统计学意义(均 P<0.05)。实验室检查结果中,四组间白细胞计数、中性粒细胞百分比、血小板计数、总胆红素、 C反应蛋白、降钙素原、红细胞沉降率、抗核抗体阳性均差异有统计学意义(均 P<0.05)。结论发热伴淋巴结肿大主要病因是感染性疾病,其次为其他类疾病,前者病毒感染多见,后者以组织坏死性淋巴结炎为主。临床可通过病人基本情况、临床特征、实验室检查进行初步鉴别诊断,淋巴结活检对诊疗有一定帮助。
英文摘要:
      Objective To investigate the etiological distribution and clinical characteristics of patients with a disease characterizedby fever combined with lymphadenopathy at first visit and improve the clinical cognition and diagnosability of the disease. Methods From January 2020 to October 2022, 163 patients with fever combined with lymphadenopathy definitely diagnosed by lymph node biopsy and pathological examination for the first visit to Shanxi Bethune Hospital were collected and retrospectively analyzed. According to the etiology, they were divided into the infectious disease group (the "infection group"), the non-infectious inflammatory disease group (the "non-infection group"), the neoplastic disease and hematopoietic system disease group (the "neoplasm and hematopoiesis group"),and the group of other diseases (the "other group"). The clinical data of gender, age, duration of fever, characteristics of lymphadenopathy, accompanying symptoms, laboratory tests, lymph node pathology and other data were analyzed.Results Among the 163 patients, there were 63 (38.7%) in the infection group, 32 (19.6%) in the non-infection group, 31 (19.0%) in the neoplasm and hematopoiesisgroup, and 37 (22.7%) in the other group. As for the clinical characteristics, the gender, age, tenderness of lymph nodes, location oflymphadenopathy (head and neck/thorax/abdomen), generalized lymphadenopathy, and body weight loss within six months ≥ 10%showed statistically significant differences among the four groups (all P<0.05). According to the laboratory results, statistically significant differences were found in leukocyte count, neutrophil percentage, platelet count, total bilirubin, C-reactive protein, procalcitonin, erythrocyte sedimentation rate, and positive antinuclear antibodies among the four groups (all P<0.05).Conclusions The etiology of afever combined with lymphadenopathy is mainly infectious diseases, followed by other diseases, the former is more common with viralinfections, and the latter is dominated by necrotizing lymphadenitis. Preliminary differential diagnosis can be made through the patient's basic condition, clinical characteristics, laboratory tests, and lymph node biopsy is helpful for clinical diagnosis and treatment.
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