Clinical characteristics and treatment analysis of suspected tuberculous pleural effusion
PENG Bo1, HUANG Jianliang2, XIA Mingkai2, HUANG Jiale2, LEI Mingsheng2,3
1. Medical College of Jishou University, Jishou 416000, China; 2. Zhangjiajie Hospital Affiliated to Hunan Normal University, Zhangjiajie 427000, China; 3. Jishou University Zhangjiajie College, Zhangjiajie 427000, China
Abstract：Objective Summary of clinical characteristics and treatment of suspected tuberculous pleural effusion (TPE), providing a basis for accurate clinical diagnosis and personalized treatment. Methods This study analyzed clinical data from 24 cases of confirmed TPE and 63 cases of suspected TPE patients at Zhangjiajie People’s Hospital between January 2021 and December 2022. The data included general information, clinical manifestations, auxiliary inspection, treatment measures, and complications. etc. This study aims to compare the TPE group and the suspected TPE group to determine if there are any differences. Results A total of 87 patients were included in this study, with a median age of 49.0(29.0, 65.0) years in the TPE group and 58.0(44.0, 74.0) years in the suspected TPE group. The median age of the suspected TPE group was significantly higher than that of the TPE group, the TPE group exhibited higher levels of lactate dehydrogenase (LDH) at 586.0(346.8, 1016.3) U/L and adenylate dehydrogenase (ADA) at 45.5(31.5, 54.2) IU/L. The median LDH/ADA ratio was 11.6(8.07, 19.4). Yellow turbidity is the most common appearance of pleural effusion, and there is a difference in the appearance of pleural effusion between the TPE group and the suspected TPE group; The most common clinical manifestations included cough, dyspnea, chest pain, fever, and night sweats. All patients tested positive for mucin qualitative analysis; 56(64.4%) patients were positive for tuberculosis antibodies; 85(97.7%) patients with Mycobacterium tuberculosis γ- Positive interferon test, After suspected empirical anti tuberculosis treatment in the TPE group, 61(96.8%) patients had reduced pleural effusion, with 2(3.2%) forming encapsulated effusion. After anti tuberculosis treatment in the TPE group, 23(95.8%) patients had reduced pleural effusion, with 1(4.2%) forming encapsulated effusion. There was no significant difference between the two groups. Conclusion Fully understanding the clinical characteristics of suspected tuberculous pleural effusion, combined with empirical anti tuberculosis treatment, can help improve diagnostic accuracy.
2024, Vol. 21 
