Study On Related Factors Of Chronic Chest Pain In Patients With Tuberculous Exudative Pleurisy

Objective:To study the relationship between chronic chest pain and gender,age,course of disease,interleukin-1beta,interleukin-6,tumor necrosis factor-alpha in pleural fluid of patients with tuberculous exudative pleurisy.And the correlation between factor-alpha,oral glucocorticoid,pumping method of the pleural effusion and pleural thickening during anti-tuberculosis treatment.Methods:From December 2016 to December 2018,basic information,diagnosis and treatment plan and pleural fluid samples of hospitalized patients with moderate to large amount of pleural effusion were collected and followed up.To study the correlation between chronic chest pain and sex,age,course of disease,and the IL-1?,IL-6,TNF-?in pleural fluid,oral glucocorticoids added and pumping method during anti-tuberculosis treatment.Among them,87patients with tuberculous exudative pleurisy who had received standard treatment with complete data and had been followed up for 12 months were included in this study,and grouped according to the different ways of diagnosis and treatment adopted by the patients.Group A:22 patients were treated with oral anti-tuberculosis drugs alone,and pleural effusion was extracted by the thoracentesis guided to color Doppler ultrasound;Group B:23 patients were treated with oral anti-tuberculosis drugs combined with glucocorticoids,and pleural effusion was extracted by thoracentesis guided to color Doppler ultrasound;Group C:21 patients were treated with oral anti-tuberculosis drugs alone.and thoracic closed drainage was performed after medical thoracoscopy;group D:21 patients were treated with oral anti-tuberculosis drugs combined with glucocorticoids,and thoracic closed drainage was performed after medical thoracoscopy.Chest CT was reexamined in the 2nd,6th and 12th month of anti-tuberculosis treatment,pleural thickening was recorded,and chest pain was assessed using the Numeric Rating Scale^[1].Results:1.Analysis of related factors of chronic chest pain in patients with tubercu-lous exudative pleurisy treated with anti-tuberculosis therapy in the 2th mont-h:taking the chest pain of patients at this follow-up as dependent variable,and related study factors as independent variables,which statistical result has sho-wed that there was difference in oral glucocorticoids,pleural thickening betwe-en patients in the chronic chest pain group or not,while there was no signific-ant difference in the other study factors?P>0.05?.2.Analysis of related factors of chronic chest pain in patients with tubercu-lous exudative pleurisy treated with anti-tuberculosis therapy in the 6th mont-h:taking the chest pain of patients at this follow-up as dependent variable,and taking study factors as independent variables,which statistical results showed that there was difference in pleural thickening between patients in the chronic chest pain group or not,while there was no significant difference in the other st-udy factors?P>0.05?.3.Analysis of related factors of chronic chest pain in patients with tubercu-lous exudative pleurisy treated with anti-tuberculosis therapy in the 12th mont-h:taking the chest pain of patients at this follow-up as dependent variable,and taking study factors as independent variables,which statistical results showed t hat there was difference in pleural thickening between patients in the chronic chest pain group or not,while there was no significant difference in the other st udy factors?P>0.05?.4.Analysis of factors related to the occurrence of chronic chest pain and the average level of chest pain score during the follow-up of tuberculous exuda-tive pleurisy patients:the overall chest pain in the second month,the sixth mo-nth and the twelfth month of anti-tuberculosis treatment was taken as the depe-ndent variable,and the study factors were taken as the independent variables.The statistical results showed that there was significant difference in pleural thi-ckening between patients in chronic chest pain group or not?P<0.05?,while the-re was no significant difference in the other factors?P>0.05?.5.Clinical diagnostic significance of pleural thickness for chronic chest pain in tuberculous exudative pleurisy patients treated with anti-tuberculosis du-ring each follow-up period,the area under ROC curve of pleural thicknes for chronic chest pain at different follow-up stages was calculated,the analysis re-sults showed that:AUC_{the 12th month}>AUC_{the 6th month}>AUC _{the 2nd month}.Conclusion:1.The addition of short-term oral glucocorticoids during anti-tuberculosi s treatment in patients with tuberculous exudative pleurisy can reduce the risk o f early chronic chest pain.2.Chronic chest pain in patients with tuberculous exudative pleurisy at diffe-rent stages is associated with pleural thickness.3.The pleural thickness of patients with tuberculous exudative pleurisy can be used to assess the risk of chronic chest pain.When pleural thickness is greater than 2.43 mm,and the risk of chronic chest pain is increased.4.The longer the follow-up time of patients with tuberculous exudative pleu-risy,and the greater the correlation between chronic chest pain and pleural thi-ckness.