Studies on tuberculosis associated obstructive pulmonary disease (TOPD) are still scarce in China, a country with a high burden of tuberculosis and chronic obstructive pulmonary disease (COPD) .

To compare clinical features and pulmonary functions between TOPD and COPD, and to explore the relationship between imaging features and pulmonary function in TOPD, aiming at providing information for improving clinicians' understanding of TOPD.

A retrospective design was adopted. TOPD (n=387) and COPD (n=364) patients were recruited from the Fourth Clinical Medical College of Xinjiang Medical University from January 2018 to November 2020. The TOPD patients were matched with COPD patients at a ratio of 1∶2 using propensity score matching based on age, gender, ethnic group and other baseline data. Clinical data and lung function indices (FEV₁/FVC, FEV₁%pre, and FVC%pre) were compared between the groups before and after matching. Imaging manifestations of TOPD patients were further described. Spearman rank correlation analysis was used to analyze the correlation of imaging features with lung function.

The two matched groups had no significant differences in sex ratio, mean age, and ethnic group distribution (P>0.05) . Compared to COPD patients, TOPD patients had mean younger age of onset, longer mean length of hospital stay, and lower mean levels of FEV₁/FVC, and FEV₁%pre (P<0.05) . Imaging examination showed that the sites of tuberculosis scar in TOPD patients were mostly in upper and lower lobes of the right lung, and some patients had signs of emphysema and bronchiectasis to a certain extent. Spearman correlation analysis showed that the number of lung lobes affected by tuberculosis was negatively correlated with FEV₁/FVC, FEV₁%pre, and FVC%pre (r_s=-0.202, P=0.011; r_s=-0.456, P<0.001; r_s=-0.442, P<0.001) .

Compared with COPD patients, TOPD patients were characterized by younger age, longer hospital stay, and severer obstructive ventilatory disorder. In addition, lung function decreased with the increase in the number of lobes affected by tuberculosis.

作为肺结核和慢性阻塞性肺疾病（COPD）的高负担国家，我国关于结核相关阻塞性肺疾病（TOPD）的相关研究仍非常匮乏。

比较TOPD与COPD临床特征及肺功能的差异，探讨TOPD患者影像学特征与肺功能变化的关系，以期提高临床医师对该病的认识。

回顾性分析新疆维吾尔自治区第四临床医学院2018年1月至2020年11月临床诊断为TOPD的患者（TOPD组）387例和COPD患者（COPD组）364例，采用倾向性评分匹配法（PSM）对两组患者进行匹配，具体设定匹配因素包括性别、年龄、民族，匹配比例为1∶2。比较TOPD组与COPD组的临床资料及肺功能指标第1秒用力呼气容积/用力肺活量（FEV₁/FVC）、第1秒用力呼气容积占预计值百分比（FEV₁%pre）、用力肺活量占预计值百分比（FVC%pre），进一步描述TOPD患者影像学表现，采用Spearman秩相关分析进行影像学与肺功能的相关性分析。

PSM匹配后，两组患者性别、年龄、民族比较，差异均无统计学意义（P>0.05）；TOPD组患者发病年龄低于COPD组，住院天数长于COPD组（P<0.05）；TOPD组FEV₁/FVC、FEV₁%pre均低于COPD组（P<0.05）。影像学表现：TOPD患者结核瘢痕发病部位多见于右肺上叶、右肺下叶，并且部分患者存在一定程度的肺气肿和支气管扩张征象。Spearman秩相关分析结果显示，受累叶数与FEV₁/FVC、FEV₁%pre、FVC%pre均呈负相关（r_s=-0.202，P=0.011；r_s=-0.456，P<0.001；r_s=-0.442，P<0.001）。

与COPD患者相比，TOPD患者具有年龄偏低、住院时间更长、肺功能阻塞性通气功能障碍更甚等特点，此外结核受累叶数与肺功能存在负相关关系。