Abstract: Objective　To investigate the causes of fever of unknown origin（FUO），in order to benefit the clinical diagnosis and treatment of this disease.Methods　In this retrospectively study，we enrolled 372 cases of FUO according to the diagnostic criteria from Tangshan Gongren Hospital from July 2014 to June 2017.We collected their data about baseline characteristics，diagnostic methods，classification of causes of FUO and outcome.Results　The clinical data of these patients are as follows：distribution of sex：184 males and 188 females；mean age：（48.0±18.3） years；number of patients without identified causes of FUO：85（accounting for 22.8% of the total）；number，diagnostic pathway and classification of causes of FUO of patients with identified causes of FUO：287 were found with identified causes，accounting for 77.2% of the total，138（48.1%） by clinical features and/or treatment response；86（30.0%） of them were diagnosed by pathogenic or serological examination，50（17.4%） by imaging examination，and 13（4.5%） by pathological or bone marrow examination，181（63.1%） of them were caused by infectious disease〔121（66.9%） by bacterial infectious disease，and 60（33.1%） by viral infectious disease〕，57（19.9%） by connective tissue disease〔including 14（24.6%） by adult onset Still's disease〕，17（5.9%） by neoplastic disease〔including 10（58.8%） by hematological tumor〕，and 32（11.1%） by other diseases〔including 15（46.9%） by subacute thyroiditis〕．Conclusion　Infectious diseases，especially brucellosis and tuberculosis，were the most common causes of FUO．Furthermore，the characteristics of the region that the patient comes from，features of the hospital that the patient treated in，patient'atmedical history，results of meticulous physical check-up，clinical characteristics，results of auxiliary and invasive examinations are all contributive to the identification of the causes of FUO.

Key words: Fever of unknown origin, Syndrome differ pathogen fact, Retrospective studies

摘要： 目的　探讨不明原因发热（FUO）的病因，以期在今后的临床工作中对FUO的诊治提供帮助。方法　回顾性选取2014年7月—2017年6月唐山市工人医院符合FUO诊断标准的患者372例。收集患者的一般情况、诊断方法、病因分类、预后。结果　372例FUO患者中，男184例，女188例；平均年龄（48.0±18.3）岁。确诊病因287例（77.2%），其中通过临床特点和/或治疗反应确诊138例（48.1%），通过病原学或血清学确诊86例（30.0%），通过影像学确诊50例（17.4%），通过病理学或骨髓象确诊13例（4.5%）；未确诊病因85例（22.8%）。287例确诊病因患者中，感染性疾病181例（63.1%），其中细菌感染121例（66.9%），病毒感染60例（33.1%）；结缔组织病57例（19.9%），其中成人Still病14例（24.6%）；肿瘤性疾病17例（5.9%），其中血液系统肿瘤10例（58.8%）；其他疾病32例（11.1%），其中亚急性甲状腺炎15例（46.9%）。结论　感染性疾病为FUO的主要病因，其中布氏菌病和结核病为主要病种。在FUO的诊断上不仅要根据地区及不同级别医院的特点，也要结合病史，仔细、反复查体，充分利用临床特点、辅助检查及有创检查的结果。

关键词: 原因不明发热, 病因辨证, 回顾性研究