| Background Pleural effusion is a common medical problem for clinicians.Tuberculous pleural effusion(TPE)is one of the main causes of human pleural effusion in China.However,the etiology of pleural effusion is also complex and diverse,and due to the different pathogenesis of different types of pleural effusion,in order to timely and accurate diagnosis and treatment,it is very important to clarify the nature of pleural effusion,especially for TPE patients.Limited to the current clinical test level,the diagnostic efficiency of TPE is not high,so it is necessary to further explore new indicators.Therefore,the diagnostic value of serum D-dimer and peripheral blood neutrophil to platelet(NPR)ratio combined with pleural effusion adenosine deaminase(ADA)and lactate dehydrogenase(LDH)for TPE was discussed.Objective To compare the levels of blood routine indexes and biochemical indexes of pleural effusion between patients with TPE and other patients with pleural effusion,to investigate the diagnostic value of serum d-dimer and NPR in combination with ADA and LDH in pleural effusion for TPE.Methods Patients admitted to the Respiratory Interventional Diagnosis and Treatment Center of Hospital from February 2019 to March 2022 were strictly selected as exudate,and thoracoscopic biopsy was used to determine the type of pleural effusion.A total of69 cases were divided into three groups according to the type of pleural effusion,and were included in the study: 38 patients with tuberculous pleural effusion,21 patients with malignant pleural effusion,10 patients with pleural effusion adjacent to pneumonia,all the patients in the three groups were taken pleural effusion before treatment for routine and biochemical examination,and blood routine examination,record the relevant data.The clinical data,such as age,sex,blood routine results,and pleural effusion-related laboratory tests were compared among the three groups.Results The sex and age of the three groups were compared with the levels of peripheral blood leukocytes,Neutrophil,monocytes,platelets and peripheral blood NPR,Neutrophil and lymphocyte Ratio(NLR),platele to lymphocytes Ratio(PLR),lymphocyte to monocyte Ratio(LMR),and the levels of Mononuclear cellleukocyte Ratio(MNLEU),ADA and LDH-ADA in pleural effusions,the difference was statistically significant(p < 0.05),the others were not statistically significant.The results of ROC curve analysis showed that the optimal cut-off value,sensitivity and specificity of TPE were 159.207 and 0.974 for PLR in peripheral blood,respectively,the specificity was 0.484,the optimal cut-off value of peripheral blood platelet was244.75 × 109/L,the sensitivity was 0.789,the specificity was 0.742,the optimal cut-off value of MNC/Leu ratio of pleural effusion was 71.05%,the sensitivity was 0.974,the specificity of pleural effusion was 0.786 × 109/L,the specificity was 0.387.The optimal cut-off value of ADA for pleural effusion was 29.50 u/L,the sensitivity was 0.974,and the specificity was 0.968.The optimal cut-off value of LDH/ADA ratio for pleural effusion was 39.97,and the sensitivity was 0.868,the specificity was 0.903.The optimal cut-off value of Ada + PLR in pleural effusion was 0.208,the sensitivity was0.947,and the specificity was 1.000 by Roc Curve Analysis The optimal cut-off value of Ada + platelet in pleural effusion was 0.718,the sensitivity was 1.000,the specificity was 0.968.The optimal cut-off value of Ada + MNC/Leu ratio in pleural effusion was0.500,the sensitivity was 1.000,the specificity was 1.000;the optimal cut-off value of ADA + LDH/ADA ratio for pleural effusion was 0.500,the sensitivity was 1.000,and the Specificity was 1.000.Conclusion The combination of serum D-dimer and peripheral blood NPR ratio combined with pleural effusion ADA and LDH has no obvious diagnostic value for TPE,but the PLR,platelet and pleural effusion MNC / LEU ratio and LDH / ADA ratio were applied to identify TPE between TPE and other pleural effusions,providing a new way and thinking for clinical diagnosis of TPE. |
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