目的 总结疑似结核性胸腔积液（TPE）的临床特点及临床治疗方案,为临床正确诊断及个体化治疗提供依据。方法 本研究纳入了2021年1月―2022年12月在张家界市人民医院就诊的24例TPE和63例疑似TPE患者的临床数据,包括一般资料、临床表现、辅助检查、治疗措施及并发症等,比较TPE组和疑似TPE组间有无差异。结果 共有87例患者被纳入到本研究中,其中TPE组的年龄中位数49.0（29.0,65.0）岁,疑似TPE组的年龄中位数58.0（44.0,74.0）岁,疑似TPE组的年龄中位数显著高于TPE组;相比于疑似TPE组,TPE组有着更高的乳酸脱氢酶（LDH）[586.0（346.8,1016.3）U/L]和腺苷酸脱氢酶（ADA）[45.5（31.5,54.2）IU/L];LDH/ADA中位数为11.6（8.07,19.4）;黄色浑浊是最常见的胸水外观,TPE组与疑似TPE组在胸水外观存在差异;咳嗽、呼吸困难、胸痛、发热、盗汗是最常见的临床表现;所有患者的黏蛋白定性实验均为阳性;56（64.4%）例患者结核抗体阳性;85（97.7%）例患者结核杆菌γ-干扰素检测阳性,疑似TPE组经验性抗结核治疗后,61（96.8%）例患者胸腔积液减少,2（3.2%）形成包裹性积液,TPE组抗结核治疗后,23（95.8%）例患者胸腔积液减少,1（4.2%）形成包裹性积液,两组间比较无明显差异。结论 充分掌握疑似结核性胸腔积液临床特点,结合经验性抗结核治疗,有助于提高诊断准确率。

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.