Li Qian, Yu Yanyan, Gao Fen, Le Shengbing, Ling Jie, Zhou Jialin
Department of Tuberculosis Internal Medicine II, Hunan Chest Hospital, Changsha, China.
Department of Medical Laboratory, Hunan Chest Hospital, Changsha, China.
J Thorac Dis. 2024 Nov 30;16(11):7408-7416. doi: 10.21037/jtd-24-989. Epub 2024 Nov 13.
Tuberculous pleuritis is the second most common extrapulmonary tuberculosis. Its prompt diagnosis and appropriate management are essential to decrease the morbidity and mortality of affected patients. We aimed to assess whether the serum sestrin 2 and fetuin-A levels can be used to diagnose early pleural involvement in patients with pulmonary tuberculosis.
We performed a cross-sectional study and enrolled patients with pulmonary tuberculosis between October 2020 and October 2022. Their demographics and clinical characteristics were recorded. The serum sestrin 2 and fetuin-A levels were detected. Early pleural involvement was determined by a chest computed tomography (CT) scan. Patients were assigned into two groups: pleural involvement versus nonpleural involvement. The characteristics of the two groups were compared. Multivariate logistic regression analysis was performed to study the relationships between the serum sestrin 2 and fetuin-A levels with pleural involvement under potential confounders. Receiver operating characteristic (ROC) curve analysis was used to examine the performance of sestrin 2 and fetuin-A determination to diagnose pleural involvement.
We enrolled 136 pulmonary tuberculosis patients, with a mean age of 50.4 (±7.3) years old, including 79 (58.1%) males. There were 89 and 47 patients with or without pleural involvement, respectively. The baseline demographics and clinical characteristics were comparable between the two groups. Compared with the patients without pleural involvement, those with pleural involvement had a higher serum sestrin 2 level but a lower serum fetuin-A level (both P<0.05). Multivariate logistic regression analysis confirmed the association of serum sestrin 2 and fetuin-A levels with pleural involvement. In addition, ROC curve analyses demonstrated that sestrin 2 and fetuin-A alone had a high sensitivity, but the combination of these two measurements had the best performance to detect pleural involvement.
High sestrin 2 and low fetuin-A serum levels can be used to evaluate early pleural involvement in patients with pulmonary tuberculosis.
结核性胸膜炎是第二常见的肺外结核病。其及时诊断和恰当治疗对于降低受累患者的发病率和死亡率至关重要。我们旨在评估血清 sestrin 2 和胎球蛋白 A 水平是否可用于诊断肺结核患者的早期胸膜受累情况。
我们进行了一项横断面研究，纳入了 2020 年 10 月至 2022 年 10 月期间的肺结核患者。记录了他们的人口统计学和临床特征。检测了血清 sestrin 2 和胎球蛋白 A 水平。通过胸部计算机断层扫描（CT）确定早期胸膜受累情况。患者被分为两组：胸膜受累组与非胸膜受累组。比较了两组的特征。进行多因素逻辑回归分析以研究在潜在混杂因素下血清 sestrin 2 和胎球蛋白 A 水平与胸膜受累之间的关系。采用受试者工作特征（ROC）曲线分析来检验 sestrin 2 和胎球蛋白 A 测定对诊断胸膜受累的性能。
我们纳入了 136 例肺结核患者，平均年龄为 50.4（±7.3）岁，其中男性 79 例（58.1%）。胸膜受累患者和非胸膜受累患者分别有 89 例和 47 例。两组的基线人口统计学和临床特征具有可比性。与非胸膜受累患者相比，胸膜受累患者的血清 sestrin 2 水平较高，但血清胎球蛋白 A 水平较低（均 P<0.05）。多因素逻辑回归分析证实了血清 sestrin 2 和胎球蛋白 A 水平与胸膜受累的关联。此外，ROC 曲线分析表明，单独的 sestrin 2 和胎球蛋白 A 具有较高的敏感性，但这两项检测的联合使用在检测胸膜受累方面表现最佳。
血清 sestrin 2 水平升高和胎球蛋白 A 水平降低可用于评估肺结核患者的早期胸膜受累情况。
