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目的 探讨原发性肺结核发展为继发性肺结核的演变过程.方法 报道1例原发性肺结核在抗结核治疗过程中发展为血播性肺结核及继发性肺结核的诊疗过程.结果 患者,男,29岁,因发热1月入院.既往曾患克隆恩病,给予英夫利昔单抗治疗.胸部CT提示纵隔淋巴结肿大,病理诊断原发综合症,给予抗结核治疗过程中发展为血播性肺结核,并进一步发展为继发性肺结核.结论 英夫利昔单抗在结核病发生发展中具有重要作用.“,”Objective To explore the evolution of primary pulmonary tuberculosis to secondary pulmonary tuberculosis.Methods The progress of a case of primary pulmonary tuberculosis in the treatment of antituberculosis transformed into blood disseminated pulmonary tuberculosis and secondary pulmonary tuberculosis were reported.Results A male,29 years old man was hospitalized for fever one month.Crohn’s disease has previously been given to the Infliximab therapy.Chest CT suggested mediastinal lymph node enlargement,pathologic diagnosis of primary syndrome,the development of antituberculosis treatment in the course of blood disseminated tuberculosis,and further development of secondary pulmonary tuberculosis.Conclusions The effects of the Infliximab on the development of tuberculosis were significant.