Abstract: Objective By analyzing the clinical data and the diagnostic efficacy of combined detection of neutrophil percentage (NEUT), hemoglobin (HGB) and D-dimer (D-D) in patients with tuberculosis combined with tuberculous pleural effusion, this study aims to identify patients with tuberculosis combined with tuberculous pleural effusion at an early stage and to guide the optimization of clinical anti-tuberculosis treatment. Method A total of 138 patients with pulmonary tuberculosis combined with tuberculous polyserositis, admitted to Anhui Chest Hospital from July 2022 to June 2024, were included as the observation group. Additionally, 146 patients with simple pulmonary tuberculosis, who were hospitalized during the same period, were included as the control group. Clinical data from two patient groups were analyzed using univariate analysis of laboratory test results including NEUT, HGB, D-D, platelet count (PLT), erythrocyte sedimentation rate (ESR), serum albumin (ALB), and hypersensitive C-reactive protein (hs-CRP). Factors demonstrating statistically significant effects were incorporated into a multivariate Logistic regression model. Receiver operating characteristics (ROC) curves were employed to evaluate diagnostic efficacy of these factors in diagnosing pulmonary tuberculosis complicated by tuberculous pleural effusion. Result There were no significant differences in the general characteristics between the observation group and the control group(age, diabetes, place of residence, occupation, marital status, gender, hypertension, type of diagnosis). There was no significant difference in white blood cell count levels between the two groups (P>0.05), while neutrophilpercentage, hemoglobin, blood platelet, ESR, serum albumin, hs-CRP, D-D showed statistically significant differences (P<0.05). The results of multi-factor Logistic regression analysis showed that NEUT and D-D levels are risk factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion, and high HGB levels are protective factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion. ROC curve analysis revealed that, among the individual indicators, D-D had the highest AUC value of 0.871.The combined detection of neutrophil percentage, hemoglobin and D-dimer had an AUC value of 0.908 (95%CI: 0.873-0.942), with a sensitivity of 84.8%, a specificity of 83.6%, and a Youden index of 0.684. Conclusion NEUT and D-D levels are risk factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion, whereas high HGB levels are protective factors for patients with pulmonary tuberculosis combined with tuberculous serous cavity effusion, and the combined prediction model of NEUT, HGB and D-D has a high diagnostic efficacy for dentifying pulmonary tuberculosis combined with tuberculous serous cavity effusion.

Key words: Pulmonary tuberculosis, Tuberculous polyserositis, Neutrophil percentage, Hemoglobin, D-dimer, Analysis of influencing factors, Diagnostic value