关键词: 结核, 肺疾病, 病理学, 临床, 诊断, 康复

Abstract:

Tuberculosis remains the single infectious disease with the highest mortality rate globally. Approximately 30% to 50% of tuberculosis patients will develop post-tuberculosis lung disease (PTLD) after treatment, and the incidence of PTLD is higher in patients with multidrug-resistant tuberculosis. PTLD can manifest as chronic respiratory abnormalities, leading to complications such as chronic obstructive pulmonary disease (COPD), imposing a heavy burden on public health systems. Focusing on the heterogeneity and precision management of PTLD subtypes, this article elaborates on the definition and classification of PTLD, and analyzes major subtypes including airway lesions, pulmonary parenchymal lesions, pulmonary vascular lesions, complications and comorbidities, as well as PTLD in children and adolescents. The pathological mechanisms involve interactions between host immune responses, pathogen residues, and environmental factors. Diagnostic methods encompass imaging, pulmonary function assessment, and biomarker detection. Breakthroughs have been made in treatment and rehabilitation strategies including pulmonary rehabilitation, pharmacotherapy, and preventive measures. However, PTLD still faces issues such as inconsistent diagnostic criteria and evaluation systems, imperfect diagnosis and treatment strategies for subtypes, weak research on subtype-related mechanisms, and insufficient research on special populations and comorbidities. In the future, it is necessary to focus on the application of AI large model (specialized all-in-one machine) technology, increase investment in public health, clarify the orientation of scientific research, and improve the precision management system around subtype heterogeneity, so as to improve the prognosis of PTLD patients.

Key words: Tuberculosis, Lung diseases, Pathology, clinical, Diagnosis, Rehabilitation