Clinical Characteristics Of Tuberculous Pleurisy In Different Age Group

Objective This study analyzed the clinical characteristics of patients in different age groups,so as to provide clinical basis for improving the level of diagnosis and treatment in the disease.Methods From March 2016 to December 2018,164 patients with tuberculous pleurisy were retrospectively enrolled in the Department of Respiratory Medicine and Infection,Affiliated Hospital of Southwest Medical University.According to the age of the patients,the patients were divided into three groups,namely the youth group,the middle-aged group and the elderly group.Analysis of clinical data of three groups of patients,including:gender,age,length of disease,complication;clinical manifestations:fatigue,anorexia,night sweats,fever,chest pain,cough,sputum,dyspnea and other symptoms;related laboratory tests:white blood cell count,medium Number of neutrophils,neutrophil count,platelets,hemoglobin,albumin,C-reactionprotein(CRP),procalcitonin(PCT),aspartate aminotransferase(Aspartate aminotransferase,AST),alanine aminotransferase(ALT),etc.;analysis of pleural effusion volume,distribution and properties,microscopic observation,pathological results.Results According to age,78 paitents(47.6%)were included in the youth group,49 paitents(29.9%)in the middle-aged group and 37 paitents(22.6%)in the elderly group.Among them,23 were female and 55 were male in the youth group;14 were male and 35 were male in the middle-aged group,10 were famel and 27 were malein the elderly group;there was no significant difference in sex ratio among the three groups(P>0.05).Compared with the youth group,the elderly group had longer course of disease and more complications(P<0.05).(1)Clinical symptoms:There was no statistical difference in fatigue,poor appetite,night sweat,dyspnea and other symptoms among the three groups(P>0.05),but there were differences in fever,chest pain,cough and expectoration among the three groups;compared with the youth group,the elderly group had more symptom of cough and expectoration(P<0.05);compared with the middle-aged and elderly group group,the youth group had more symptom of chest pain(P<0.001);in addition,compared with the middle-aged group and elderly group,the youth group had more symptom of fever(P<0.05);(2)Laboratory results:There was no significant difference in the number of leukocytes,neutrophils,the proportion of neutrophils,platelets,hemoglobin,CRP,PCT,AST,ALT,interferon gamma and tuberculosis chip among the three groups(P>0.05),but there was significant difference in the number of leukocytes between the three groups.Compared with the youth and middle-aged group,the number of leukocytes was increased in elderly group(P<0.05).(3)The characteristics of pleural effusion:Compared with the middle-aged and elderly group,the proportion of pleural effusion was increased in the youth group;compared with youth group,the proportion of bloody pleural effusion was was increased in the elderly group(P<0.05);in addition,there was no statistical difference in the lactate dehydrogenase,albumin of pleural effusion among the three groups(P>0.05).(4)Morphological and pathological results under thoracoscopy:There was no significant difference in the pathological results between the three groups(P>0.05);compared with the elderlly group,pleural nodules were more in the youth group(P<0.05).Conclusions Compared with the youth group,the elderly group had longer course of disease and more complications.The Clinical symptoms,laboratory examination,performance under the thoracoscope and pleural effusion characteristics of tuberculous pleurisy are atypical.Therefore,in clinical practice,elderly patients with pleural effusion are recommended to perform thoracoscopic pleural biopsy,and the biopsy tissue should be tested for tuberculous bacillus nucleic acid,so as to early diagnose tuberculous pleurisy in the elderly.