Clinical characteristics and factors associated with airflow obstruction among patients with post-tuberculosis lung disease

To analyze the clinical characteristics and factors associated with airflow obstruction in patients with post-tuberculosis lung disease. This retrospective cross-sectional study included 667 patients screened after successful anti-tuberculosis treatment in Lishui City between January 2024 and December 2025. Based on a post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC) ratio below the lower limit of normal, participants were classified into an airflow obstruction group ( n = 97) and a non-airflow obstruction group ( n = 570). Symptoms were compared between the two groups, and univariate and multivariate logistic regression analyses were performed. The overall prevalence of PTLD-related airflow obsrruction is 14.5% (95% CI: 11.9%–17.2%). The frequencies of cough, sputum production, chest tightness, dyspnea, and weight loss were significantly higher in the airflow obstruction group than in the non-airflow obstruction group ( p < 0.05). Univariate analysis demonstrated that age, sex, BMI, radiological score and chest CT findings including bronchiectasis, emphysema, and tuberculosis-related scarring were significantly associated with airflow obstruction following successful treatment of pulmonary tuberculosis (all p < 0.05). Multivariate logistic regression analysis identified BMI < 18.5 kg/m² (odds ratio [OR] = 9.634, 95% confidence interval [CI]: 5.187–17.892), emphysema (OR = 8.591, 95% CI: 4.084–18.069), bronchiectasis (OR = 3.750, 95% CI: 1.504–9.350),previous tuberculous pleurisy (OR = 2.678, 95% CI: 1.128–6.359), pulmonary tuberculous scars (OR = 2.184, 95% CI: 1.148–4.154) and increasing CT radiological score (OR = 1.313, 95% CI: 1.207–1.427) and age (OR = 1.031, 95% CI: 1.010–1.053) as independent factors associated with airflow obstruction (all p < 0.05). Older patients with pulmonary tuberculosis, low body mass index (BMI), extensive residual tuberculous lesions, and concurrent emphysema, bronchiectasis, tuberculous pleurisy or tuberculous scars carry a high risk of developing post-tuberculosis airflow obstruction. Early pulmonary function testing can help identify airflow limitation in this population at an early stage and enable timely intervention. Not applicable.