发烧和不知源的炎症在21世纪
Christina Antoniadou1, Efstratios Gavriilidis1, Petros Chatzopoulos1
1First Department of Internal Medicine and Laboratory of Molecular Hematology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
European journal of internal medicine
|August 21, 2025
概括
不知源发烧 (FUO) 和不知源发炎 (IUO) 的诊断复杂. 最近的趋势显示未诊断的疾病 (UI) 和非传染性炎症疾病 (NIID) 增加,特别是在高收入地区.
科学领域:
- 内部医学
- 诊断的挑战
- 临床综合征
背景情况:
- 不知源的发烧 (FUO) 和不知源的炎症 (IUO) 给内科医生带来了诊断上的挑战.
- 已建立的分类包括传染病 (INF),非传染性炎症病 (NIID),恶性瘤 (MAL),各种 (MISC) 和未诊断的疾病 (UI).
- 从历史上看,感染是FUO的主要原因,但最近的趋势显示,尤其是在高收入环境中,人们更倾向于UI和NIID.
研究的目的:
- 审查FUO和IUO的诊断方法和不断变化的病因.
- 突出临床病史和检查在识别潜在诊断线索 (PDC) 的重要性.
- 讨论 PET/CT 和下一代测序 (NGS) 等先进诊断技术的作用和局限性.
主要方法:
- 对FUO/IUO的诊断分类和病因分布的审查.
- 强调病史和身体检查的作用,以确定PDC.
- 评估现代技术 (PET/CT,NGS) 和新兴技术 (转基因NGS,细胞因子测定).
主要成果:
- FUO病因转向UI和NIID,特别是在高收入国家.
- IUO较少与感染有关,NIID是最常见的原因.
- 像NGS和细胞因子测试这样的先进技术是有前途的,但需要选择性,PDC引导的应用.
结论:
- 对于FUO/IUO诊断,细致的临床评估仍然至关重要.
- 虽然先进的技术有助于诊断,但以PDC为指导的成本效益和选择性使用至关重要.
- 需要进一步研究潜在的机制和基于病理生理学的诊断工具,因为UI是欧洲FUO的主要原因.
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