Cupido Gordon, Günther Gunar
Department of Internal Medicine, Katutura State Hospital, Windhoek, Namibia.
Department of Pulmonology and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Medical Sciences, University of Namibia, School of Medicine, Windhoek, Namibia.
Indian J Tuberc. 2024 Jan;71(1):64-72. doi: 10.1016/j.ijtb.2023.04.001. Epub 2023 Apr 11.
Post Tuberculosis lung disease (PTLD) and post tuberculosis sequelae is a global and poorly recognized problem, amplified by social factors and immunocompromising conditions, inadequate treatment, lack of effective prevention of tuberculosis (TB) infection and disease. As a disease, it remained until recently poorly defined, with studies heterogenous with regards to regions, population demographics, risk factors, cohort sizes, and methods. Pathophysiologically, even successfully treated pulmonary TB disease has sequelae i.e. involving central and peripheral airways, lung parenchyma and pleura, resulting in airway narrowing and dilatation, fibrocavitation and emphysema, pulmonary vascular changes as well as pleural fibrosis. Functionally patients have airflow limitation, restrictive disease or a mixture of both not rarely associated with respiratory, or even ventilatory failure. Quality of life is often impaired through disability, TB relapse, superinfections and through increased susceptibility to reinfection and persistent inflammation, leading to progressive lung function decline and an increased risk of cardiovascular disease and cancer. Premature mortality due to PTLD is very likely, but poorly described.
肺结核后肺部疾病（PTLD）和肺结核后遗症是一个全球性问题，但却未得到充分认识，社会因素、免疫功能低下状况、治疗不充分、缺乏对结核病（TB）感染和疾病的有效预防使其进一步恶化。作为一种疾病，直到最近它的定义仍不明确，不同地区、人群特征、风险因素、队列规模及研究方法的研究存在差异。从病理生理学角度来看，即使是成功治愈的肺结核疾病也会留下后遗症，即累及中央和外周气道、肺实质和胸膜，导致气道狭窄和扩张、纤维空洞和肺气肿、肺血管改变以及胸膜纤维化。在功能方面，患者存在气流受限、限制性疾病或两者兼有的情况，且常与呼吸甚至通气衰竭相关。生活质量往往因残疾、结核病复发、重复感染以及再次感染易感性增加和持续性炎症而受损，导致肺功能逐渐下降以及心血管疾病和癌症风险增加。PTLD导致的过早死亡很可能发生，但相关描述较少。
