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ENGLISH ABSTRACT
结核后肺疾病的异质性特征及综合管理进展
盛子康
盖晓燕
孙永昌
作者及单位信息
·
DOI： 10.3760/cma.j.cn112147-20240701-00375
Advances in the understanding of heterogeneous characteristics and comprehensive management of post-tuberculosis lung disease
Sheng Zikang
Gai Xiaoyan
Sun Yongchang
Authors Info & Affiliations
Sheng Zikang
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
Gai Xiaoyan
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
Sun Yongchang
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
·
DOI： 10.3760/cma.j.cn112147-20240701-00375
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摘要

结核后肺疾病（PTLD）是一组表现为咳嗽、乏力、气短等症状，同时伴有胸部影像学改变，部分患者同时存在肺功能异常的异质性疾病。30%~50%的肺结核患者在完成抗结核治疗后仍存在不同形式的PTLD，给个人和社会带来极大的负担。PTLD病因及发病机制复杂，是宿主免疫反应、病原体及环境因素相互作用的结果。由于对该类疾病认识不足，常导致忽视及误诊。因此有必要加强临床医师对PTLD的认识，本综述介绍了近年来PTLD研究进展及未来研究方向。

ABSTRACT

Post-tuberculosis lung disease (PTLD) is a heterogeneous group of diseases characterized by symptoms such as cough, fatigue and shortness of breath, along with chest imaging abnormalities, and impaired lung function in some patients. Even after successful treatment, nearly 30%-50% of patients continue to suffer from various forms of PTLD, causing great harm to individuals and societies. The etiology and pathogenesis of PTLD are complex and involve the interaction of the host immune response, pathogens and environmental factors. Due to the limited understanding of PTLD, it is often underdiagnosed and misdiagnosed. Therefore, it is crucial to increase clinicians′ awareness of this condition. This review aims to summarize recent advances in the diagnosis and treatment of PTLD.

Gai Xiaoyan, Email: mocdef.3ab6197lfw18yxg
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引用本文

盛子康,盖晓燕,孙永昌. 结核后肺疾病的异质性特征及综合管理进展[J]. 中华结核和呼吸杂志,2025,48(02)：181-185.

DOI:10.3760/cma.j.cn112147-20240701-00375

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全球每年因传染病死亡的人数中，结核病占据很大一部分，其中最常见的是肺结核 ［ 1 ］ 。世界卫生组织（WHO）报告估计2023年全球新发结核人数1 080万人，造成125万人死亡 ［ 2 ］ 。结核分枝杆菌（MTB）可经多种途径传播至体内，最常见的途径是通过吸入活动性肺结核患者咳嗽或打喷嚏时携带MTB的飞沫气溶胶进行传播，肺结核是最常见的发病形式 ［ 3 ］ 。在对肺结核患者治疗结束后的随访发现，部分患者遗留了长期后遗症，表现为咳嗽、乏力、气短等症状，同时伴胸部影像学改变及肺功能异常。因此，专家们提出结核后肺疾病的概念（post tuberculosis lung disease，PTLD） ［ 4 , 5 ］ 。2019年第一届国际结核后肺疾病研讨会明确提出PTLD的定义：无论有或无症状，存在至少部分归因于既往肺结核病的慢性呼吸系统异常的临床表现 ［ 6 ］ 。我国是世界上第二位结核高负担国家，结核病患者数量众多，仅次于印度 ［ 2 ］ 。近年来，PTLD在国内也逐渐受到关注 ［ 7 , 8 ］ 。PTLD的病因仍有待进一步研究，目前认为很可能是宿主免疫反应、病原体及环境因素共同或相互作用的结果 ［ 9 ］ 。PTLD具有较高的发病率、致残率和病死率，严重影响了患者的生活质量，对个人、家庭及社会造成了严重的负担，应当引起重视 ［ 10 ］ 。本文聚焦近年来国内外PTLD各项研究，阐述其异质性特征及综合管理的认识及进展，同时介绍了烟草烟雾暴露对结核病的影响，并重点介绍了近年来结核相关慢性阻塞性肺疾病（简称慢阻肺病）相关的指南更新及诊治新进展，以期提高临床医生对该类疾病的认识。
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备注信息
A
盖晓燕，Email： mocdef.3ab6197lfw18yxg
B
盛子康, 盖晓燕, 孙永昌. 结核后肺疾病的异质性特征及综合管理进展[J]. 中华结核和呼吸杂志, 2025, 48(2): 181-185. DOI: 10.3760/cma.j.cn112147-20240701-00375.
C
所有作者声明无利益冲突
D
首都卫生发展科研专项 (2022-2G-40910)
北京大学扬帆计划-青年培育基金 (BMU2024YFJHPY014)
北医三院临床重点项目 (BYSYZD2022014)
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