结核后肺曲霉病的临床诊疗研究进展  

Advances in the clinical diagnosis and treatment of post-tuberculosis chronic pulmonary aspergillosis

作　　者：秦丽莉 杨澄清 麦洪珍 徐齐峰 薛新颖 路希维 Qin Lili;Yang Chengqing;Mai Hongzhen;Xu Qifeng;Xue Xinying;Lu Xiwei(Department of Radiology,Dalian Public Health Clinical Center,Dalian 116031,China;Department of Respiratory and Critical Care Medicine,Wuhan Pulmonary Hospital,Wuhan 430000,China;Department of Tuberculosis,Dalian Public Health Clinical Center,Dalian 116031,China;Department of Respiratory and Critical Care Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing 100080,China)

机构地区：[1]大连市公共卫生临床中心放射科,大连116031 [2]武汉市肺科医院呼吸与危重症医学科,武汉430000 [3]大连市公共卫生临床中心结核内科,大连116031 [4]首都医科大学附属北京世纪坛医院呼吸与危重症医学科,北京100080

出　　处：《中国防痨杂志》2025年第4期498-504,共7页Chinese Journal of Antituberculosis

基　　金：大连市“登峰计划”医学重点专科建设项目经费资助(21020021T000000006625)。

摘　　要：结核病仍是全球最大的传染病杀手,与此同时,结核后肺疾病(post-tuberculosis lung disease,PTLD)对患者躯体、心理、经济等各方面造成的不良影响日益得到重视。结核后慢性肺曲霉病(PTLD-CPA)是指肺结核治疗过程中或停止治疗后继发的慢性肺曲霉感染。由于CPA与肺结核在临床表现和影像特征等方面有诸多相似之处,因此,容易造成误诊、误治,可见,开展曲霉菌感染早期筛查和早期干预具有必要性。本文对PTLD-CPA的流行病学特征、临床特征、治疗及筛查相关内容进行归纳,旨在探讨PTLD-CPA的防控要点,尝试建立结核病全生命周期健康管理的新模式。Tuberculosis(TB)remains the leading cause of death from infectious diseases globally.Increasing recognition has been given to the long-term consequences of post-tuberculosis lung disease(PTLD),which profoundly affect patients’physical health,psychological well-being,and socioeconomic stability.Among these sequelae,post-tuberculosis chronic pulmonary aspergillosis(PTLD-CPA)is a persistent Aspergillus infection that arises during or after TB treatment.The substantial overlap in clinical manifestations and radiological features between CPA and TB frequently leads to misdiagnosis and inappropriate treatment,further exacerbating disease progression and associated morbidity.This underscores the critical need for early screening and timely intervention for Aspergillus infection.This review consolidates current evidence on the epidemiology,clinical characteristics,diagnostic modalities,treatment strategies,and screening protocols for PTLD-CPA.By delineating key priorities for prevention and disease management,we propose a comprehensive,life-cycle-based health management framework for TB,integrating early detection,targeted therapeutic interventions,and long-term surveillance to mitigate the enduring burden of PTLD-CPA.

关 键 词：结核 肺 曲霉菌病 结核后肺疾病 综述 

分 类 号：R52[医药卫生—内科学] R563[医药卫生—临床医学]