The Journal of Practical Medicine >
The current status and diagnostic and therapeutic progress of common post⁃tuberculosis pulmonary disease
Received date: 2025-06-06
Online published: 2025-10-10
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.
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 . DOI: 10.3969/j.issn.1006-5725.2025.19.005
| [1] | World Health Organization. Global tuberculosis report 2023［C］. Geneva： World Health Organization， 2023. |
| [2] | AULD S C， BARCZAk A K， BISHAI W， et al. Pathogenesis of Post-Tuberculosis Lung Disease： Defining Knowledge Gaps and Research Priorities at the Second International Post-Tuberculosis Symposium［J］. Am J Respir Crit Care Med， 2024，210（8）：979-993. doi:10.1164/rccm.202402-0374so |
| [3] | PATIL S， NARKAR S， RAKA V， et al. ‘Destroyed lung’ as post tuberculosis sequel： A preventable stigma of ‘disease of concern’ of millennium［J］. Saudi J Med，2023， 8 ：112-119. doi:10.36348/sjm.2023.v08i03.007 |
| [4] | AKALU T Y， CLEMENTS A C A， LIYEW A M， et al. Risk factors associated with post-tuberculosis sequelae： A systematic review and meta-analysis［J］. E Clin Med， 2024，77：102898. doi:10.1016/j.eclinm.2024.102898 |
| [5] | ROMANOWSKI K， BAUMANN B， BASHAM C A， et al. Long-term all-cause mortality in people treated for tuberculosis： A systematic review and meta-analysis［J］. Lancet Infect Dis， 2019，19（10）：1129-1137. doi:10.1016/s1473-3099(19)30309-3 |
| [6] | ALLWOOD B W， VAN DER ZALM M M， AMARAL A F S， et al. Post-tuberculosis lung health： Perspectives from the First International Symposium［J］. Int J Tuberc Lung Dis， 2020，24（8）：820-828. doi:10.5588/ijtld.20.0067 |
| [7] | BYRNE A， ALLWOOD B， SCHOEMAN I， et al. “Post tuberculosis”： The urgent need for inclusion of lung health outcomes in tuberculosis treatment trials［J］. Eur Respir J， 2023，62（3）：2300950. doi:10.1183/13993003.00950-2023 |
| [8] | HERMANS S M， AKKERMAN O W， MEINTJES G， et al. Post-tuberculosis treatment paradoxical reactions［J］. Infection， 2024，52（5）：2083-2095. doi:10.1007/s15010-024-02310-0 |
| [9] | MEGHJI J， AULD S C， BISSON G P， et al. Post-tuberculosis lung disease： Towards prevention， diagnosis， and care［J］. Lancet Respir Med， 2025，13（5）：460-472. doi:10.1016/s2213-2600(24)00429-6 |
| [10] | 唐神结，李亮. 应重视结核后肺疾病的防治［J］.中华结核和呼吸杂志，2022，45（10）：951-954. |
| [11] | KEMPKER R R， SALINDRI A D， AVALIANI T， et al. High rates of post-tuberculosis lung disease among persons successfully treated for drug-susceptible and resistant tuberculosis［J］. Thorax， 2025，thorax-2024-222350. doi:10.1136/thorax-2024-222350 |
| [12] | XING Z， SUN T， JANSSENS J P， et al. Airflow obstruction and small airway dysfunction following pulmonary tuberculosis： A cross-sectional survey［J］. Thorax， 2023，78（3）：274-280. doi:10.1136/thoraxjnl-2021-218345 |
| [13] | BYRNE A， AL-HINDAWI Y， PLIT M， et al. The prevalence and pattern of post tuberculosis lung disease including pulmonary hypertension from an Australian TB service； a single-centre， retrospective cohort study［J］. BMC Pulm Med， 2025，25（1）：84. doi:10.1186/s12890-025-03549-5 |
| [14] | CUPIDO G， GUNTHER G. Post tuberculosis lung disease and tuberculosis sequelae： A narrative review［J］. Indian J Tuberc， 2024，71（1）：64-72. doi:10.1016/j.ijtb.2023.04.001 |
| [15] | SANKAR P， RAMOS R B， CORRO J， et al. Fatty acid metabolism in neutrophils promotes lung damage and bacterial replication during tuberculosis［J］. PLoS Pathog， 2024，20（10）：e1012188. doi:10.1371/journal.ppat.1012188 |
| [16] | WANG X， LIN W， LI H， et al. Soluble programmed cell death ligand-1 as a predictive biomarker for severity and poor prognosis in pulmonary tuberculosis［J］. Ann Med， 2025，57（1）：2527364. doi:10.1080/07853890.2025.2527364 |
| [17] | MALEFANE L， MAARMAN G. Post-tuberculosis lung disease and inflammatory role players： Can we characterise the myriad inflammatory pathways involved to gain a better understanding？［J］ .Chem Biol Interact， 2024，387：110817. doi:10.1016/j.cbi.2023.110817 |
| [18] | SEHGAL I S， DHOORIA S， MUTHU V， et al. Burden， clinical features， and outcomes of post-tuberculosis chronic obstructive lung diseases［J］. Curr Opin Pulm Med， 2024，30（2）：156-166. doi:10.1097/mcp.0000000000001026 |
| [19] | ARORA V K， RAJPAl S. Tuberculosis and COPD： A multimorbidity syndrome［J］. Indian J Tuberc， 2025，25（）：S3-S4. doi:10.1016/j.ijtb.2025.02.010 |
| [20] | 袁建林，冯海沜，罗远明，等. 慢性阻塞性肺疾病急性加重合并活动性肺结核的临床特征、预测因素及短期预后 ［J］. 中国呼吸与危重监护杂志， 2024， 23 （9）： 609-616. |
| [21] | LIN Y， LIU Y， ZHANG G， et al. Is It Feasible to Conduct Post-Tuberculosis Assessments at the End of Tuberculosis Treatment under Routine Programmatic Conditions in China？［J］.Trop Med Infect Dis， 2021，6（3）：164. doi:10.3390/tropicalmed6030164 |
| [22] | 楚伟杰，毋娜，张珊珊. 慢性阻塞性肺疾病患者合并结核分枝杆菌感染的危险因素分析 ［J］. 现代医药卫生， 2025， 41（3）： 638-640+645. |
| [23] | LEUNG C L， JERENE D， MEGHJI J， et al. Post-TB sequelae and care： A systematic review and synthesis of qualitative research［J］. IJTLD Open， 2025，2（6）：339-345. doi:10.5588/ijtldopen.25.0084 |
| [24] | GAI X， ALLWOOD B， SUN Y. Advances in the awareness of tuberculosis-associated chronic obstructive pulmonary disease［J］. Chin Med J Pulm Crit Care Med， 2024，2（4）：250-256. doi:10.1016/j.pccm.2024.08.008 |
| [25] | RHEE C K， YOO K H， LEE J H， et al. Clinical characteristics of patients with tuberculosis-destroyed lung［J］. Int J Tuberc Lung Dis， 2013，17（1）：67-75. doi:10.5588/ijtld.12.0351 |
| [26] | 王益德，田宗祥，李争，等. 基于倾向性评分匹配的结核相关阻塞性肺疾病患者肺功能及影像学特征分析［J］. 中国全科医学，2022，25（14）：1718-1723. |
| [27] | KIM S J， LEE J， PARK Y S， et al. Effect of airflow limitation on acute exacerbations in patients with destroyed lungs by tuberculosis［J］. J Korean Med Sci， 2015，30（6）：737-742. doi:10.3346/jkms.2015.30.6.737 |
| [28] | MENON B， NIMA G， DOGRA V， et al. Evaluation of the radiological sequelae after treatment completion in new cases of pulmonary， pleural， and mediastinal tuberculosis［J］. Lung India， 2015，32（3）：241-245. doi:10.4103/0970-2113.156233 |
| [29] | MALECHE-OBIMBO E， ODJIANBO M A， NJERI L， et al. Magnitude and factors associated with post-tuberculosis lung disease in low- and middle-income countries： A systematic review and meta-analysis［J］. PLOS Glob Public Health， 2022，2（12）：e0000805. doi:10.1371/journal.pgph.0000805 |
| [30] | 古丽茹·阿热斯兰，祖菲亚·努尔买买提，黄霞，等. 结核后支气管扩张的临床特征及危险因素 ［J］. 现代生物医学进展， 2022， 22 （18）： 3469-3473. |
| [31] | CHOI H， XU J F， CHOTIRMALL S H， et al. Bronchiectasis in Asia： A review of current status and challenges［J］. Eur Respir Rev， 2024，33（173）：240096. doi:10.1183/16000617.0096-2024 |
| [32] | ARBAT A， GANDHASIRI D， CHOURASIA S， et al. Clinical， radiological and microbiological profile of post-tuberculosis versus nontuberculosis bronchiectasis patients at a tertiary care centre of Central India： A retrospective study［J］. Tuberk Toraks，2025，73（2）：132-143. doi:10.5578/tt.2025021014 |
| [33] | NIGHTINGALE R， CHINOKO B， LESOSKY M， et al. Respiratory symptoms and lung function in patients treated for pulmonary tuberculosis in Malawi： A prospective cohort study［J］. Thorax， 2022，77（11）：1131-1139. doi:10.1136/thoraxjnl-2021-217190 |
| [34] | CHOI H， LEE H， RA S W， et al. Clinical Characteristics of Patients with Post-Tuberculosis Bronchiectasis： Findings from the KMBARC Registry［J］. J Clin Med， 2021，10（19）：4542. doi:10.3390/jcm10194542 |
| [35] | SEO H， SI CHA， PARK J， et al. Hemoptysis as the presenting manifestation of bronchiectasis-associated hospitalization in Korea［J］. J Thorac Dis， 2023，15（7）：3636-3645. doi:10.21037/jtd-22-1541 |
| [36] | BONGOMIN F. Post-tuberculosis chronic pulmonary aspergillosis： An emerging public health concern［J］. PLoS Pathog， 2020，16（8）：e1008742. doi:10.1371/journal.ppat.1008742 |
| [37] | HUISAMEN T， THOMSON H， HARRINGTON K R V， et al. A retrospective study exploring chronic pulmonary aspergillosis in post-tuberculosis lung disease patients［J］. J Thorac Dis， 2025，17（1）：320-332. doi:10.21037/jtd-24-1062 |
| [38] | AJAYABABU A， MEENA V P， SETHI P， et al. Allergic Bronchopulmonary Aspergillosis in Patients With Prior Pulmonary Tuberculosis： A Study on the Burden， Clinic-Radiological Features， Treatment Outcomes and Comparison With Chronic Pulmonary Aspergillosis and Post-Tubercular Lung Disease Patients［J］. Mycoses， 2025，68（2）：e70034. doi:10.1111/myc.70034 |
| [39] | 秦丽莉，杨澄清，麦洪珍，等. 结核后肺曲霉病的临床诊疗研究进展［J］. 中国防痨杂志， 2025， 47 （4）： 498-504. |
| [40] | TAYLOR J， BASTOS M L， LACHAPELLE-CHISHOLM S， et al. Residual respiratory disability after successful treatment of pulmonary tuberculosis： A systematic review and meta-analysis［J］. E Clin Med， 2023，59：101979. doi:10.1016/j.eclinm.2023.101979 |
| [41] | SINGLA R， SINGHAL R， RATHORE R， et al. Risk factors for chronic pulmonary aspergillosis in post-TB patients［J］. Int J Tuberc Lung Dis， 2021，25（4）：324-326. doi:10.5588/ijtld.20.0735 |
| [42] | NGUYEN N T B， LE NGOC H， NGUYEN N V， et al. Chronic Pulmonary Aspergillosis Situation among Post Tuberculosis Patients in Vietnam： An Observational Study［J］. J Fungi （Basel）， 2021，7（7）：532. doi:10.3390/jof7070532 |
| [43] | KWIZERA R， KATENDE A， BONGOMIN F， et al. Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda： A case series［J］. J Med Case Rep， 2021，15（1）：140. doi:10.1186/s13256-021-02721-9 |
| [44] | 中华医学会呼吸病学分会.慢性阻塞性肺疾病伴肺曲霉病诊治和管理专家共识［J］.中华结核和呼吸杂志， 2024，47（7）：604-622. |
| [45] | RATNAKUMAR S， HAYWARD S E， DENNENY E K， et al. Post-pulmonary tuberculosis lung function： A systematic review and meta-analysis［J］. Lancet Glob Health，2025，13（6）：e1020-e1029. doi:10.1016/s2214-109x(25)00105-6 |
| [46] | DANIELS K J， IRUSEN E， PHARAOH H， et al. Post-tuberculosis health-related quality of life， lung function and exercise capacity in a cured pulmonary tuberculosis population in the Breede Valley District， South Africa［J］. S Afr J Physiother， 2019，75（1）：1319. doi:10.4102/sajp.v75i1.1319 |
| [47] | ZHU L， WANG B， GU J，et al. IFNγ-secreting T cells that highly express IL-2 potently inhibit the growth of intracellular M. tuberculosis in macrophages［J］. Front Immunol， 2024，15：1469118. doi:10.3389/fimmu.2024.1469118 |
| [48] | AL-ZUBAIDI M I， LAFI S A， ABDULATEEF Y M. Cytokine Dysregulation in pulmonary Tuberculosis： The role of TNF-α/IL-10 and TNF-α/TGF-β ratios as severity indicators［J］. Hum Immunol， 2025，86（2）：111256. doi:10.1016/j.humimm.2025.111256 |
| [49] | 盖林林，孙维策，褚锦锦，等. 活动性肺结核相关巨噬细胞M1/M2极化的改变及ESAT6对巨噬细胞极化的影响 ［J］. 实用医学杂志， 2024， 40 （20）： 2867-2873. |
| [50] | ALLWOOD B W， VAN DER ZALM M M， AMARAL A F S， et al. Post-tuberculosis lung health： Perspectives from the First International Symposium［J］. Int J Tuberc Lung Dis， 2020，24（8）：820-828. doi:10.5588/ijtld.20.0067 |
| [51] | YUM H K， PARK I N. Effect of inhaled tiotropium on spirometric parameters in patients with tuberculous destroyed lung［J］. Tuberc Respir Dis （Seoul）， 2014，77（4）：167-171. doi:10.4046/trd.2014.77.4.167 |
| [52] | YUE J Q， TANG R D， GUAN W J. Autologous transplantation of lung progenitor cells comes into reality for bronchiectasis［J］. Cell Rep Med， 2024，5（11）：101821. doi:10.1016/j.xcrm.2024.101821 |
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