根据炎症状况和年龄的条件诊断准确性,用于诊断结核溢出
Da Som Jeon1, Sung-Hoon Kim2, Jang Ho Lee3
1Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Nowon Eulji Medical Center, University of Eulji, Seoul, South Korea.
BMC pulmonary medicine
|October 20, 2023
概括
炎症会影响腺脱氨酶 (ADA) 和淋巴细胞/中性粒细胞 (L/N) 比率测试的准确性,用于诊断结核性多叶流液. 诊断标准显示在高度炎症条件下敏感性降低,需要临床考虑.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 诊断的准确性 诊断的准确性
背景情况:
- 结核性流出呈现出基于炎症的不同细胞占主导地位 (淋巴细胞占主导地位至中性细胞占主导地位).
- 现有的诊断标准,如腺脱氨酶 (ADA) 水平和淋巴细胞/中性细胞 (L/N) 比率,需要在不同的临床条件下进行评估.
研究的目的:
- 在不同炎症状态下,评估结核性多叶流液的ADA和L/N比标准的诊断性能.
- 为了研究炎症标记物的影响,如C-反应蛋白 (CRP) 和白细胞 (WBC) 在诊断准确性上.
主要方法:
- 在阿桑医疗中心从2009年到2019年的肺液数据的回顾性分析.
- 评估ADA (≥50U/L) 和L/N比率 (≥0.75) 标准,使用蒙特卡罗模拟对年龄,CRP,WBC和乳酸脱酶 (LD) 分层的子组进行评估.
- 接收器运行特征曲线下的面积 (AUROC) 用于评估模型性能.
主要成果:
- 在分析的2,034名患者中,有229人 (11.26%) 患有结核溢出. 基线的ADA显示平均AUROC为0.88.
- 升高的CRP和WBC水平与中性友结核溢出相关,显著降低了测试灵敏度 (例如,高CRP的~33%).
- 诊断模型的AUROC在较高的WBC和CRP组下降,表明炎症状态的准确性下降. 没有明显的趋势被观察到与增加的LD或年龄.
结论:
- 结核性肺溢液的ADA和L/N比标准的诊断准确性受到患者炎症状况的显著影响.
- 临床医生必须谨慎行事,并考虑这些诊断标志物的可靠性降低在患者呈现高水平的炎症.
相关概念视频
Pulmonary Tuberculosis IV
145
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
145
Pulmonary Tuberculosis III
339
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
339
Pneumonia III: Complications and Assessment
242
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
242
Pulmonary Tuberculosis II
243
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
243
Pericarditis II: Clinical Features and Diagnostic Tests
9
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
9
Pleural Effusion II: Symptoms and Management
188
Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
188


