Wu Yan-Hua, Wang Jun-Li, Wang Mao-Shui
Department of Lab Medicine, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Lab Medicine, Shandong Public Health Clinical Center, Shandong University, Jinan, China.
Front Pediatr. 2021 Oct 29;9:751386. doi: 10.3389/fped.2021.751386. eCollection 2021.
Until now, the factor of tuberculous empyema (TE) in children with pleural tuberculosis (TB) remains unclear. Therefore, a retrospective study was conducted to assess the factors associated with the presence of TE in children. Between January 2006 and December 2019, consecutive children patients (≤ 15 years old) with suspected pleural TB were selected for further analysis. Empyema was defined as grossly purulent pleural fluid. The demographic, clinical, laboratory, and radiographic features were collected from the electrical medical records retrospectively. Univariate and multivariate logistic regressions were used to explore the factors associated with the presence of TE in children with pleural TB. A total of 154 children with pleural TB (definite, 123 cases; possible, 31 cases) were included in our study and then were classified as TE ( = 27) and Non-TE ( = 127) groups. Multivariate analysis revealed that surgical treatment (age- and sex-adjusted OR = 92.0, 95% CI: 11.7, 721.3), cavity (age- and sex-adjusted OR = 39.2, 95% CI: 3.2, 476.3), pleural LDH (>941 U/L, age- and sex-adjusted OR = 14.8, 95% CI: 2.4, 90.4), and temperature (>37.2°C, age- and sex-adjusted OR = 0.08, 95% CI: 0.01, 0.53) were associated with the presence of TE in children with pleural TB. Early detection of the presence of TE in children remains a challenge and several characteristics, such as surgical treatment, lung cavitation, high pleural LDH level, and low temperature, were identified as factors of the presence of TE in children with pleural TB. These findings may improve the management of childhood TE.
迄今为止，胸膜结核（TB）患儿发生结核性脓胸（TE）的因素仍不明确。因此，开展了一项回顾性研究，以评估与儿童TE发生相关的因素。2006年1月至2019年12月期间，选取连续的疑似胸膜TB的儿童患者（≤15岁）进行进一步分析。脓胸定义为肉眼可见脓性胸腔积液。回顾性地从电子病历中收集人口统计学、临床、实验室和影像学特征。采用单因素和多因素逻辑回归分析探讨胸膜TB患儿发生TE的相关因素。本研究共纳入154例胸膜TB患儿（确诊123例；可能31例），然后分为TE组（=27）和非TE组（=127）。多因素分析显示，手术治疗（年龄和性别校正OR=92.0，95%CI：11.7，721.3）、空洞（年龄和性别校正OR=39.2，95%CI：3.2，476.3）、胸腔乳酸脱氢酶（LDH）（>941 U/L，年龄和性别校正OR=14.8，95%CI：2.4，90.4）和体温（>37.2°C，年龄和性别校正OR=0.08，95%CI：0.01，0.53）与胸膜TB患儿发生TE有关。早期发现儿童TE的存在仍然是一项挑战，手术治疗、肺空洞、高胸腔LDH水平和低温等几个特征被确定为胸膜TB患儿发生TE的因素。这些发现可能会改善儿童TE的管理。
