纤维蛋白原/白蛋白比值与结核性胸膜炎患者胸膜粘连的关系  

Relationship between fibrinogen/albumin ratio and pleural adhesion in patients with tuberculous pleurisy

作　　者：李新军 曹玲莉[1] 黄凤姨[1] 邱琦 邓科兰[1] 吴展陵[1] LI Xin-jun;CAO Ling-li;HUANG Feng-yi;QIU Qi;DENG Ke-lan;WU Zhan-ling(Department of Respiratory Medicine,Central Hospital of Xiaogan,Xiaogan,Hubei 432000,China)

机构地区：[1]孝感市中心医院呼吸与危重症医学科,湖北孝感432000

出　　处：《临床肺科杂志》2023年第6期854-857,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨纤维蛋白原/白蛋白比值(fibrinogen to albumin ratio,FAR)与结核性胸膜炎患者发生胸膜粘连的关系及其对胸膜粘连严重程度的预测价值。方法收集2019年9月至2021年12月在我院行胸腔镜手术确诊结核性胸膜炎的111名患者的临床资料。住院期间测定其血清ADA、LDH、Alb、CRP和Fib。探讨其临床资料及实验室检测与胸膜粘连的相关性。结果有胸膜粘连的患者病程更长,血清ADA含量、CRP、Fib、FAR均更高,而Alb水平降低,且上述指标与胸膜粘连程度均有相关性,其中FAR的相关性最强(Rho=0.349,P<0.001)。在预测结核性胸膜炎患者发生胸膜粘连方面,FAR的预测价值最高(AUC=0.754,95%CI 0.661~0.848,P<0.001),当其最佳临界值为14.55时,预测胸膜粘连的敏感度为70.5%,特异度为87.9%;在有胸膜粘连的患者中,FAR>14.55的患者更易发生重度胸膜粘连。结论FAR可用于预测结核性胸膜炎患者胸膜粘连程度,对于高FAR的患者,应早期干预,早期治疗。Objective To investigate the relationship between fibrinogen to albumin ratio(FAR)and pleural adhesion in patients with tuberculous pleurisy and its predictive value for the severity of pleural adhesion.Methods The clinical data of 111 patients with tuberculous pleurisy diagnosed by thoracoscopy in our hospital from September 2019 to December 2021 were collected.Their serum ADA,LDH,Alb,CRP and Fib were measured during hospitalization.The correlation between its clinical data and laboratory tests and pleural adhesion was investigated.Results Patients with pleural adhesion had a longer course of disease,higher ADA,CRP,Fib,and FAR levels,while Alb levels were decreased,and the above indicators were correlated with the degree of pleural adhesion,among which FAR had the strongest correlation(Rho=0.349,P<0.001).In predicting the occurrence of pleural adhesion in patients with tuberculous pleurisy,FAR had the highest predictive value(AUC=0.754,P<0.001).When its optimal cutoff value was 14.55,the sensitivity for predicting pleural adhesion was 70.5%and the specificity was 87.9%.Among patients with pleural adhesion,patients with FAR>14.55 were more likely to develop severe pleural adhesion.Conclusion FAR can be used to predict the degree of pleural adhesion in patients with tuberculous pleurisy.For patients with high FAR,early intervention and timely treatment should be carried out.

关 键 词：结核性胸膜炎 纤维蛋白原/白蛋白比值 胸膜粘连 

分 类 号：R521.7[医药卫生—内科学]