常见结核后肺疾病的诊疗进展

doi:10.3969/j.issn.1006-5725.2025.19.005

Abstract

Abstract:

Tuberculosis remains the leading cause of death from a single infectious agent worldwide. China is still one of the countries with a high burden of tuberculosis. The structural and functional damage to lung tissue caused by post-tuberculosis pulmonary disease （PTLD） imposes a considerable disease burden on people. However， due to the insufficient understanding of post-tuberculosis lung diseases in the past， the long-term management of this disease has been lacking for the post-tuberculosis population. This article elaborates on the epidemiology and hazards， pathogenesis， clinical manifestations， diagnostic methods， treatment and preventive measures of common PTLD， with the aim of enhancing the awareness and attention of tuberculosis physicians to PTLD. It also summarizes the limitations in the etiological mechanism， diagnosis and treatment methods of PTLD， as well as the urgency of in-depth research.

Key words: post-tuberculosis pulmonary disease, pathogenesis, clinical manifestations, diagnostic methods

CLC Number:

R521

Xiaoning LIU,Yaxue LIANG,Hua. WANG. The current status and diagnostic and therapeutic progress of common post⁃tuberculosis pulmonary disease[J]. The Journal of Practical Medicine, 2025, 41(19): 2985-2990.

Figures/Tables 1

References 52

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项目	PTLD-AFO	COPD
临床概况	大多是肺结核后有持续症状的年轻人	大多数是既往有吸烟史或环境暴露（生物燃料或其他）的老年人
症状	咳嗽、呼吸困难或咯血［合并慢性肺曲霉病（CPA）或支气管扩张］	呼吸困难或咳痰
发病机制	气道异常愈合、气道平滑肌破坏、支气管周围纤维化、肺实质破坏伴空洞形成	黏液腺肥大、杯状细胞增生，气道平滑肌肥大，呼吸性细支气管、肺泡导管和肺泡破坏
肺功能	固定性气流阻塞	固定或部分可逆性气流阻塞
胸部CT表现	空洞、结节、马赛克征、胸膜纤维化等	气道壁增厚、肺气肿
自然病程	可以是静态的，也可以是进行性的，并伴有多次急性加重	病情进展，反复出现急性加重
治疗	根据表型，包括气管镜介入治疗、吸入支气管扩张剂等	吸入支气管扩张剂

The current status and diagnostic and therapeutic progress of common post⁃tuberculosis pulmonary disease

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