Clinical Significance Of Plasma D-Dimer In Tuberculous Pleural Effusion And Partial Pulmonary Disease

Objective: To explore the clinical characteristics of Tuberculous pleural effusion(TPE)and the differences and clinical significance of plasma d-dimer in TPE,Heart failure(HF)related pleural effusion,parapneumonic effusion(PE)and lung cancer-related Malignant pleural effusion(MPE).Methods: A total of 310 patients with pleural effusion who met the inclusion criteria in The Department Of Respiratory Medicine Of The First Hospital Of Lan Zhou University from 2016 to 2017 were collected,which were divided into TPE group and non-TPE group,including 196 patients in TPE group and 114 patients in non-TPE group.The age,gender,clinical symptoms,chest volume and position of patients in the TPE group were collected,and statistical analysis was conducted using Excel XP and SPSS 22.0 statistical software to explore the clinical characteristics of TPE.The blood d-dimer values of 310 patients were counted,and SPSS 22.0 statistical software was used for statistical analysis.The counting data were expressed as x s,and the comparison between groups was conducted by anova,P<0.05 was statistically significant.Receiver operator characteristic curve(ROC)was made with d-dimer numerical threshold to analyze the sensitivity,specificity,predictive value and accuracy of d-dimer for TPE diagnosis.Area under the ROC curve(AUC)> 0.5 was considered of diagnostic value.Results: In the TPE group,there were 107 patients under 39 years old,accounting for 54.6% of the total population,There were 114 men and 82 women.There were 110 cases with pleural effusion on the right side,accounting for 56%.The symptoms of young patients with TPE are mainly fever and chest pain,while the symptoms of elderly patients are chest tightness,shortness of breath,fatigue and wasting.The d-dimer value in the TPE group was significantly higher than that in the non-TPE group,and the difference was statistically significant(P < 0.05).The optimal cutoff value of d-dimer in the diagnosis of TPE was 3ug/ml,and the sensitivity of the diagnosis of TPE at this cutoff value was 63.8%,the specificity was 82.5%,the positive predictive value was 85%,the negative predictive value was 67%,and the accuracy was 78%.Conclusion: 1.TPE tends to occur in young and middle-aged men,with the majority of pleural effusion on the right side,the ratio of male to female is about 1.5:1.2.The clinical manifestations of TPE are related to age.The main clinical manifestations of middle-aged and young patients are fever and chest pain,while the elderly patients are fatigue,chest tightness,shortness of breath and emaciation.3.The positive rate and average value of d-dimer in the TPE group were the highest.Compared with the non-tpe group,the difference was statistically significant.D-dimer can be used as a convenient auxiliary index for the identification of TPE and MPE.