关键词: 肺血栓栓塞症, 肺结核, D-二聚体, 高敏肌钙蛋白I

Abstract: Objective To compare the clinical characteristics of patients with pulmonary tuberculosis complicated by pulmonary thromboembolism (PTE) versus those with PTE alone, and to provide a reference for the clinical identification of pulmonary tuberculosis in patients with PTE. Method A total of 53 patients diagnosed with PTE at Guangzhou Chest Hospital from January 1 2021 to May 1 2024 were enrolled. Among them, 14 patients with pulmonary tuberculosis and PTE were assigned to the study group, and the remaining 39 patients with PTE alone served as the control group. An exploratory analysis was performed on the two groups. For continuous variables, normality was assessed using the Shapiro-Wilk test. Data conforming to a normal distribution were expressed as mean±standard deviation and compared using the independent samples t-test; data not conforming to a normal distribution were expressed as median (interquartile range) and compared using the Mann-Whitney U test. Categorical variables were presented as counts (percentages), and intergroup comparisons were performed using appropriate methods based on theoretical frequencies (Pearson's chi-square test or Fisher's exact test). Result The study group (n=14) had a lower body mass index and higher incidences of cough and expectoration than the control group (n=39) (all P<0.05). Plasma D-dimer level in the study group was 9.7 (6.8, 14.2) mg/L, which was higher than that in the control group [2.0 (1.0, 3.2) mg/L]; the High-sensitivity cardiac troponin I level was 47.0 (36.2, 65.7) ng/L in the study group versus 4.3 (2.2, 8.0) ng/L in the control group, with statistically significant differences (P<0.001).No statistically significant differences were observed between the two groups in terms of age, gender composition, or PTE risk factors (P>0.05). Similarly, no statistically significant differences were found regarding clinical manifestations such as fever, chest pain, dyspnea, hemoptysis, white blood cell counts, or CTPA imaging findings between the two groups (P>0.05). There was also no significant difference in PTE-related in-hospital mortality between the two groups (P>0.05). Conclusion Compared with patients with PTE alone, patients with pulmonary tuberculosis combined with PTE have a lower body mass index, a higher prevalence of cough and expectoration, and more pronounced elevations in plasma D-dimer and High-sensitivity cardiac troponin I levels.

Key words: Pulmonary thromboembolism, Pulmonary tuberculosis, D-dimer, High-sensitivity cardiac troponin I