【摘要】 目的：分析结核性胸膜炎（TBP）患者预后不良的影响因素。方法：选取2024年2月至2025年3月该院收治的200例TBP患者进行横断面研究。所有患者均治疗3个月，根据TBP患者是否预后不良将其分为发生组和未发生组。比较两组基线资料，并采用Logistic回归分析TBP患者预后不良的影响因素。结果：200例TBP患者预后不良48例，占24.00%，纳入发生组，未预后不良152例，占76.00%，纳入未发生组；两组年龄、性别、体质量指数、吸烟史、饮酒史、胸腔积液量、胸腔积液细胞数、应用激素治疗、双侧积液、胸膜增厚、包裹性积液等占比比较，差异均无统计学意义（P>0.05）；发生组发病至就诊时间≥30 d、胸腔积液蛋白总量≥50 g/L、红细胞沉降率（ESR）≥25 mm/1 h、白细胞介素-27(IL-27)≥50μg/L、焦虑自评量表（SAS）评分≥60分、Morisky服药依从性量表（MMAS-8）评分<6分等占比均高于未发生组，差异有统计学意义（P<0.05）;Logistic回归分析结果显示，发病至就诊时间≥30 d、胸腔积液蛋白总量≥50 g/L、ESR≥25 mm/1 h、IL-27≥50μg/L、SAS评分≥60分、MMAS-8评分<6分等均为TBP患者预后不良的危险因素（OR>1,P<0.05）。结论：发病至就诊时间≥30 d、胸腔积液蛋白总量≥50 g/L、ESR≥25 mm/1 h、IL-27≥50μg/L、SAS评分≥60分、MMAS-8评分<6分等均为TBP患者预后不良的危险因素。更多还原

【Abstract】 Objective: To analyze influencing factors of poor prognosis in patients with tuberculous pleurisy(TBP). Methods: A crosssectional study was conducted on 200 TBP patients admitted to this hospital from February 2024 to March 2025. All patients were treated for 3 months. They were divided into an occurrence group and a non-occurrence group based on whether poor prognosis occurred. The baseline data of the two groups were compared. Logistic regression analysis was used to analyze the influencing factors of poor prognosis in the TBP patients. Results: Among the 200 TBP patients, 48(24.00%) had poor prognosis and were included in the occurrence group, while 152(76.00%) did not have poor prognosis and were included in the non-occurrence group. There were no significant differences in the proportions of age, gender, body mass index, smoking history, drinking history, pleural effusion volume, pleural effusion cell count, hormone treatment, bilateral effusion, pleural thickening, and encapsulated effusion between the two groups(P>0.05). The proportions of the patients with a duration from onset to treatment ≥ 30 days, total pleural effusion protein≥50 g/L, erythrocyte sedimentation rate(ESR)≥25 mm/1 h, interleukin-27(IL-27)≥50 μg/L, self-rating anxiety scale(SAS) score≥60, and Morisky medication adherence scale(MMAS-8) score<6 in the occurrence group were higher than those in the non-occurrence group, and the differences were statistically significant(P<0.05). Logistic regression analysis showed that a duration from onset to treatment≥30 days, total pleural effusion protein≥50 g/L, ESR≥25 mm/1 h, IL-27≥50 μg/L, SAS score≥60, and MMAS-8 score<6 were all risk factors for poor prognosis in the TBP patients(OR>1, P<0.05). Conclusions: A duration from onset to treatment≥30 days, total pleural effusion protein≥50 g/L, ESR≥25 mm/1 h, IL-27≥50 μg/L, SAS score≥60, and MMAS-8 score<6 are the risk factors for poor prognosis in the TBP patients.更多还原