系统性红斑狼疮（SLE）是一种多器官多系统受累的慢性自身免疫性疾病。感染是导致SLE患者发病和死亡最常见的原因之一。与普通人群相比，SLE患者感染事件发生风险显著增加。其中，活动性结核病（ATB）作为单一传染性疾病的重要死因，与SLE间的相互作用较为复杂。一方面SLE患者因本身免疫功能异常及激素和免疫抑制剂的使用，更易发生结核病；另一方面，结核分枝杆菌感染诱发的免疫激活又是SLE发生发展的危险因素之一，两者互为因果。当SLE患者并发ATB时，临床症状往往不典型，很难与SLE本身活动或其他感染相鉴别，易造成漏诊及误诊；且病情重，发生播散性肺结核及肺外结核比例显著升高。本文就SLE患者发生ATB的临床特点进行综述，为更好地认知SLE合并ATB提供一定依据。

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, characterized by a multitude of autoantibodies and multiorgan damage. Infections are the most common causes of the morbidity and mortality of patients with SLE. The risk of infection in SLE patients is significantly higher than the general population. Active tuberculosis (ATB), as a single infectious etiology of death, has a complex relationship with SLE. On the one hand, patients with SLE always increased the susceptibility to tuberculosis due to autoimmune disorder and the use of glucocorticoids and immunosuppressants. On the other hand, immune activation induced by tuberculosis infection can predispose patients to the occurrence and development of SLE; the two causes interact as both cause and effect. When patients with SLE are complicated with ATB, the clinical symptoms are often atypical, and it is difficult to distinguish it from SLE itself or other infections, which is easy to cause missed diagnosis and misdiagnosis, and the disease is serious, and the proportion of disseminated tuberculosis and extrapulmonary tuberculosis increased significantly. This paper reviews the clinical characteristics of ATB of patients with SLE, which provides some basis for better cognition of SLE complicated with ATB in clinical practice.