在淋巴细胞占主导地位的排泄性肺形状的患者中,结核性肺流的诊断评分系统:一项开发研究
Jeerawat Kaewwinud1, Sireethorn Pienchitlertkajorn1, Kamolphop Koomtanapat1
1Department of Medicine, Surin Hospital, Surin, Thailand.
Heliyon
|February 9, 2024
概括
新的诊断工具有助于识别淋巴细胞占主导地位的排泄性流 (LPE) 患者的结核性流 (TPE). 这些分数有助于在腺脱氨酶 (ADA) 测试呈阴性或不可用时进行诊断,从而改善治疗的开始.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 诊断医学 诊断医学
背景情况:
- 由于结核培养的效用较低,诊断结核性多叶流血 (TPE) 是一个挑战.
- 建议使用腺脱氨酶 (ADA),但成本昂贵,可用性有限.
- 需要在泰国患有淋巴细胞占主导地位的排泄性肺溢液 (LPE) 的患者中使用TPE的诊断工具,特别是具有负面或不可用的ADA结果.
研究的目的:
- 在LPE患者中开发和验证TPE的诊断预测工具.
- 创建模型,用于阴性肺部液 ADA 和 ADA 测试不可用的场景.
- 提供评分系统,以帮助临床决策TPE诊断.
主要方法:
- 在苏林医院对LPE患者的回顾性分析.
- 使用多变量逻辑回归的两个模型的开发:模型1 (ADA负) 和模型2 (ADA不可用).
- 衍生出临床评分系统 (圆和计数),切割点基于实现与ADA测试相比较的正预测值 (PPV).
主要成果:
- 分析了359名患者 (166名TPE,193名非TPE).
- 确定了关键预测因素:年龄<40岁,发烧,多叶液蛋白≥5g/dL,男性性别,多叶液颜色,ADA≥20U/L.
- 两种模型都显示出出色的区别 (AuROC 0.850.89);分数系统在特定的切线点实现了高PPV.
结论:
- 开发的诊断工具 (Lex-2P2A和Lex-2P-MAC) 有助于在LPE患者中区分TPE和非TPE.
- 这些工具是有价值的,当肺部液体ADA是负的或不可用时.
- 实施可能会改善TPE的诊断和加快治疗的启动.
相关概念视频
Pulmonary Tuberculosis IV
143
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...
143
Pulmonary Tuberculosis III
327
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:
327
Pleural Effusion I: Introduction
997
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
997
Pleural Effusion II: Symptoms and Management
174
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:
174
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.5K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.5K
Pulmonary Tuberculosis II
237
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...
237


