Department of Respiratory Medicine, Gandhi Medical College & Hamidia Hospital Bhopal, MP, India.
Department of General Medicine, Gandhi Medical College & Hamidia Hospital, Bhopal, MP, India.
Indian J Tuberc. 2024 Oct;71(4):405-409. doi: 10.1016/j.ijtb.2023.07.006. Epub 2023 Jul 31.
Pleural effusion indicates an imbalance between pleural fluid formation and removal. Classified into exudative and transudative, with common symptoms of dry cough, dyspnea and pleuritic chest pain. Confirmed etiology has to be established for effective treatment.
Correlate clinical and biochemical profile of various etiologies of pleural effusion.
MATERIALS & METHODS: Retrospective observational study of 2 years in the department of respiratory medicine, GMC Bhopal on 280 cases of pleural effusion.
Most common etiology was tubercular 202 (72.4%) followed by malignant in 36 (12.8%). With respect to tubercular, malignant pleural effusion has relative risk (RR) of 0.138 (p value < 0.05) in the age group of 51-60 years, which is statistically significant. Patients of tuberculosis complained of fever 158 (78.2%) whereas with malignancy complained of chest pain 16 (44.4%) followed by hemoptysis 12 (33.3%). For hemoptysis, with respect to tubercular, malignant effusion has RR of 5.68 (p value < 0.05) which is significant. History of smoking was significant in malignant effusion with RR of 2.57 (p value < 0.05) as compared to tubercular. Pleural fluid ADA was >70 in 83.7% in tubercular effusion, glucose was <60 mg/dl in 79% tubercular, malignant and bacteriological cause, LDH was >1000 in 88.4% in bacteriological and 72.3% in malignant effusion.
Lack of tools for confirming diagnosis leads to diagnostic dilemma and delay in treatment initiation, leading to deterioration and untoward fatality in some cases. Our goal is early diagnosis by correlating clinical symptoms with biochemical profile and help initiate rapid treatment.
胸腔积液表明胸腔液形成和清除之间失去平衡。分为渗出性和漏出性,常见症状有干咳、呼吸困难和胸痛。为了有效治疗,必须确定病因。
分析胸腔积液各种病因的临床和生化特征。
对在博帕尔 GMC 呼吸医学系进行的为期 2 年的 280 例胸腔积液病例进行回顾性观察研究。
最常见的病因是结核性 202 例(72.4%),其次是恶性肿瘤 36 例(12.8%)。结核性胸腔积液在 51-60 岁年龄组的相对风险(RR)为 0.138(p 值<0.05),具有统计学意义。结核病患者有 158 例(78.2%)发热,而恶性肿瘤患者有 16 例(44.4%)胸痛,随后是 12 例(33.3%)咯血。对于咯血,与结核性相比,恶性胸腔积液的 RR 为 5.68(p 值<0.05),具有统计学意义。恶性胸腔积液中吸烟史有统计学意义,RR 为 2.57(p 值<0.05),与结核性相比。结核性胸腔积液中的 ADA 大于 70 占 83.7%,葡萄糖小于 60mg/dl 占 79%,结核性、恶性和细菌性胸腔积液中,LDH 大于 1000 占 88.4%,恶性胸腔积液中占 72.3%。
缺乏确诊工具导致诊断困难,治疗开始延迟,导致一些情况下病情恶化和不良后果。我们的目标是通过将临床症状与生化特征相关联,早期诊断,帮助快速启动治疗。