| 田江华,涂军伟,盛怡俊,陈慧君.结核性胸膜炎患者胸腔镜下表现与病程的相关性研究[J].浙江中西医结合杂志,2022,32(12): |
| 结核性胸膜炎患者胸腔镜下表现与病程的相关性研究 |
| Analysis of the Relationship Between Phenotype and Course of Tuberculous Pleurisy under Thoracoscope |
| 投稿时间：2022-02-21 修订日期：2022-09-15 |
| DOI： |
| 中文关键词: 结核性胸膜炎 胸腔镜 病程 相关性 |
| 英文关键词:tuberculous pleurisy thoracoscopy course of disease relevance |
| 基金项目:IL-35在结核性胸膜炎中的表达及机制研究 金华市科学技术局公益类项目 计划编号:2017-4-006 |
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| 中文摘要: |
| 【摘要】 目的 分析结核性胸膜炎胸腔镜下表现与病程的相关性，评估内科胸腔镜对结核性胸膜炎的诊断价值。方法 回顾性分析我院2014年1月至2022年1月经胸腔镜检查的131例结核性胸膜炎患者临床特点、胸腔镜下表型及病理类型。结果 131例结核性胸膜炎胸腔镜下类型如下：充血、水肿（18例，14.5%）；粟粒样结节（28例，21.4%）；大小不等结节（52例39.7%）；胸膜粘连、胸膜增厚（32例，24.4%）。按发病病程将结核性胸膜炎患者分为四组：A组（病程≤7d）18例（13.74%），中位年龄29岁；B组（7d〈病程≤14d）35例（26.72%），中位年龄50岁；C组（14d<病程≤28d）40例（30.53%），中位年龄52±16.3岁；D组（病程>28d）38例（29.01%），中位年龄60岁。采用Spearman相关分析法分析病程与内科胸腔镜下表现的相关性及病程与年龄的相关性。提示结核性胸膜炎病程与镜下表型呈中度正相关（r=0.532， P<0.001）；病程与年龄呈低度正相关（r=0.324， P<0.05）。不同胸腔镜下表型的病理类型之间并无差异（P<0.05），75.57%（99/131）的TBP壁层胸膜具有典型的结核病理改变。B组和C组的TBP患者干酪样肉芽肿病理改变多于D组患者（P<0.05）。结论 结核性胸膜炎患者内科胸腔镜下表型多样，通过分析结核性胸膜炎镜下表型，可协助其诊断分型，指导治疗。 |
| 英文摘要: |
| [Abstract] Objective To analyze the relationship between phenotype and course of tuberculous pleurisy under thoracoscope, and to evaluate the diagnostic value of thoracoscopy in tuberculous pleurisy.Methods The clinical characteristics, thoracoscopic phenotype and pathological type of 131 patients from June 2014 to June 2022 were retrospectively analyzed.Results The thoracoscopic types of 131 cases of tuberculous pleurisy were as follows: congestion and edema (198 cases, 14.5%); miliary nodules (28 cases, 21.4%); nodules of different sizes (52 cases, 39.7%); Thickening (32 cases, 24.4%). The patients with tuberculous pleurisy were divided into four groups according to the course of disease: group I (duration≤7d), 18 cases (13.74%), with a median age of 29 years; The median age was 50 years; 40 cases (30.53%) in group III (14 days < course of disease ≤ 28 days), with a median age of 52±16.3 years; and 38 cases (29.01%) in group VI (with a course of disease > 28 days), with a median age of 60 years. Spearman correlation analysis was used to analyze the correlation between the course of disease and the appearance of medical thoracoscopy, and the correlation between the course of disease and age. It suggested that the course of tuberculous pleurisy had a moderate positive correlation with the microscopic type (r=0.532, P<0.001); the course of the disease had a low positive correlation with age (r=0.324, P<0.05). There was no difference between the pathological types of different thoracoscopic types (P<0.05), and 75.57% (99/131) of TBP parietal pleura had typical tuberculosis pathological changes. The pathological changes of TBP patients in group II and group III were more than those in group IV (P<0.05).Conclusion There are various types of tuberculous pleurisy patients under medical thoracoscopy. By analyzing the type of tuberculous pleurisy, it can assist in diagnosis and classification and guide treatment. |
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