摘要
目的探讨伴有发热的小肠溃疡的病因和发热特点,以期为临床上伴有发热的小肠溃疡的诊断及鉴别诊断提供参考依据。方法回顾性分析2010年5月至2018年5月在南方医科大学南方医院住院诊治,经内镜检查发现小肠溃疡,同时伴有发热的患者资料。结果共收集到符合条件的病例177例,免疫相关性疾病129例(72.9%),其中克罗恩病占比最高(121/129,93.8%),其次为白塞病(6/129,4.7%)。余依次为肠结核21例(11.9%),淋巴瘤13例(7.3%),其他少见病10例(5.6%),无法确诊疾病4例(2.3%)。免疫相关性疾病、其他少见病和无法确诊疾病主要表现为不规则的低中热,发热时间多不规律。肠结核以不规则或间歇性午后低热多见,淋巴瘤则主要表现为间歇性或不规则高热,发热时间不规律。结论伴有发热的小肠溃疡病因复杂多样,较难鉴别,发热特点可为病因分类提供参考,但还需结合详尽的病史、相关辅助检查、试验性治疗等进行综合分析。
Objective To explore the etiology and fever characteristics of small intestinal ulcer with fever,in order to provide reference for clinical diagnosis and differential diagnosis of small intestinal ulcer with fever.Methods Clinical data of patients with small intestinal ulcer and fever in Nanfang hospital of Southern Medical University from May 2010 to May 2018 were retrospectively analyzed.Results A total of 177 patients met the above conditions.The most common causes were immune-related diseases,including Crohn’s disease(CD)which accounted for the highest proportion(121/129,93.8%),followed by Behcet’s disease(BD)(6/129,4.7%).The remaining causes were intestinal tuberculosis(21,11.9%),lymphoma(13,7.3%),other rare causes(10,5.6%),and 4 cases with unknown etiology(2.3%).Immune-related diseases,other rare and undiagnosed diseases were mainly characterized by irregularly low and moderate fever with irregular time.Intestinal tuberculosis was mostly characterized by irregularly or intermittently low fever in the afternoon,while the main manifestation of lymphoma was intermittently or irregularly high fever with irregular time.Conclusion The etiology of small intestinal ulcer with fever is complex and diverse,which is difficult to distinguish.The characteristics of fever can provide a reference for etiology classification,but it needs to be combined with detailed history,relevant auxiliary examination,experimental treatment and other comprehensive analysis.
作者
赵珍玉
张義捷
何璇昱
张亚历
顾红祥
ZHAO Zhen-yu;ZHANG Yi-jie;HE Xuan-yu;ZHANG Ya-li;GU Hong-xiang(Department of Gastroenterology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Chin)
出处
《现代消化及介入诊疗》
2020年第2期153-157,162,共6页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
广东省自然科学基金(2017A030313472)
广东省胃肠疾病重点实验室、广东省胃肠疾病生物工程中心和广东省科技计划项目(No.2017B02029003)
关键词
小肠溃疡
发热
病因
分析
Small intestinal ulcer
Fever
Etiology
Analysis
