Abstract: Objective To investigate the clinical characteristics of patients with tuberculous constrictive pericarditis(TBCP) and analyze its risk factors,so as to provide a reference for the clinical diagnosis of TBCP. Method Clinical data of 118 patients diagnosed with tuberculous pericarditis(TBP) at Chongqing Public Health Medical Center from July 2023 to June 2025 were retrospectively collected.Patients were divided into a TBCP group(n=67) and a non-TBCP group(n=51) based on the progression to constrictive pericarditis. Clinical data were compared between the two groups. A stratified analysis was performed based on whether pericardial puncture was performed.Multivariate logistic regression was used to identify independent risk factors for TBCP. Result Compared with patients in the non-TBCP group, patients in the TBCP group had a longer disease course, and their main clinical symptom was cough accompanied by dyspnea on exertion, with statistically significant differences between the groups (all P<0.05). Laboratory examination results showed that compared with the non-TBCP group, the levels of troponin, N-terminal pro-brain natriuretic peptide, total bilirubin, and indirect bilirubin in the TBCP group were significantly higher, while the levels of direct bilirubin and erythrocyte sedimentation rate were significantly lower, and all the above inter-group differences were statistically significant (all P<0.05). Imaging characteristics showed that patients in the TBCP group had a characteristic septal bounce, accompanied by pericardial thickening, a small amount of pericardial effusion, and biatrial enlargement. Hemodynamic examination suggested that compared with the non-TBCP group, the superior vena cava pressure, right atrial pressure, right ventricular pressure, pulmonary artery pressure, and pulmonary artery wedge pressure in the TBCP group were increased, while the cardiac index and cardiac output were decreased, and all the above differences were statistically significant (all P<0.05). Intervention analysis showed that the incidence of pericardial constriction was 40.0% (22/55) in the pericardiocentesis group, which was significantly lower than 71.4% (45/63) in the non-pericardiocentesis group, with a statistically significant difference (P=0.001). The results of multivariate Logistic regression analysis indicated that the duration of illness (OR=1.480, 95%CI: 1.150-1.910), pericardial thickness (OR=1.470, 95%CI: 1.090-2.000), and pericardial effusion volume (OR=0.920, 95%CI: 0.860-0.980) were independent influencing factors for the occurrence of TBCP. Conclusion Patients with TBCP have a longer course of disease, mainly presenting with cough accompanied by fatigue, along with characteristic changes in laboratory tests, imaging, and hemodynamics, and pericardiocentesis can reduce the risk of its occurrence. Prolonged duration of illness and increased pericardial thickness are independent risk factors for TBCP, while increased pericardial effusion volume is an independent protective factor. Clinically, attention should be paid to the above characteristics, and early intervention should be strengthened to reduce the incidence risk.

Key words: Constrictive pericarditis, Tuberculosis, Pericardiocentesis, Clinical characteristics, Risk factors