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肺部结核菌感染的主要特征是免疫病理损伤。继发性肺结核可对肺组织造成不同程度的损害,其病理改变主要有肉芽肿形成、干酪样坏死和空洞、组织纤维化等,使肺结构变形,并对呼吸功能和肺免疫功能产生严重不良影响。本文通过对肺结核免疫病理研究的相关文献回顾,阐述了肉芽肿、干酪样坏死、纤维化的结构与形成机制及这些病变在肺结核病程中的意义。目前的抗结核化疗能杀灭并控制结核菌增殖,但难以改善损害的肺结构,只有阐明重症肺结核的免疫病理机制才能更好地用免疫治疗来减轻肺结核病对肺组织的破坏。
The main feature of pulmonary tuberculosis infection is immunopathological damage. Secondary pulmonary tuberculosis can cause varying degrees of lung damage, the pathological changes are mainly granuloma formation, caseous necrosis and cavitation, tissue fibrosis, the structural deformation of the lungs, and respiratory function and lung immune function serious adverse influences. In this review, we review the relevant literature on immunopathological studies of pulmonary tuberculosis and elucidate the mechanisms of granuloma, caseous necrosis, fibrosis and their mechanisms and the significance of these pathologies in the course of pulmonary tuberculosis. The current anti-tuberculosis chemotherapy can kill and control the proliferation of Mycobacterium tuberculosis, but it is difficult to improve the damaged lung structure. Only elucidate the immune pathology of severe tuberculosis in order to better use immunotherapy to reduce the damage of pulmonary tuberculosis on lung tissue.