Gai Xiaoyan, Allwood Brian, Sun Yongchang
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Center for Chronic Airway Diseases, Peking University Health Science Center, Peking University, Beijing 100191, China.
Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Academic Hospital, Cape Town 7505, South Africa.
Chin Med J Pulm Crit Care Med. 2024 Oct 18;2(4):250-256. doi: 10.1016/j.pccm.2024.08.008. eCollection 2024 Dec.
Tuberculosis (TB) significantly increases the risk of developing chronic obstructive pulmonary disease (COPD), positioning TB-associated COPD (TB-COPD) as a distinct category within the spectrum of respiratory diseases prevalent, especially in low- and middle-income countries. This condition results from the body's immune response to TB, leading to prolonged inflammation and consequent persistent lung damage. Diagnostic approaches, particularly post-bronchodilator spirometry, are vital for identifying airflow obstruction and confirming TB-COPD. Furthermore, exploring potential biomarkers is crucial for a deeper insight into the pathogenesis of TB-COPD and the improvement of treatment strategies. Currently, this condition is primarily managed using inhaled bronchodilators, with cautious use of inhaled corticosteroids advised owing to the increased risk of developing TB. This review delves into the epidemiology, clinical manifestations, pulmonary function, and imaging characteristics of TB-COPD, scrutinizing current and prospective biomarkers and therapeutic strategies. Furthermore, it underscores the necessity for focused research to bridge the knowledge and treatment gaps in this complex condition.
结核病（TB）显著增加了患慢性阻塞性肺疾病（COPD）的风险，使结核病相关慢性阻塞性肺疾病（TB-COPD）成为普遍存在的呼吸道疾病谱中的一个独特类别，尤其是在低收入和中等收入国家。这种情况是由于人体对结核病的免疫反应导致长期炎症以及随之而来的持续性肺损伤。诊断方法，特别是支气管扩张剂激发试验后的肺功能测定，对于识别气流受限和确诊TB-COPD至关重要。此外，探索潜在的生物标志物对于深入了解TB-COPD的发病机制和改善治疗策略至关重要。目前，这种疾病主要使用吸入性支气管扩张剂进行治疗，鉴于患结核病风险增加，建议谨慎使用吸入性糖皮质激素。本综述深入探讨了TB-COPD的流行病学、临床表现、肺功能和影像学特征，审视了当前和潜在的生物标志物以及治疗策略。此外，它强调了开展针对性研究以填补这一复杂疾病在知识和治疗方面差距的必要性。
