Abstract: Objective To study the expression level of circulating miRNA in active pulmonary tuberculosis patients and its predictive value for disease. Methods One hundred and ten patients with active pulmonary tuberculosis from January,2015 to December,2016 were selected as the observation group.At the same time,45 cases of other pulmonary diseases were selected as the control group.Forty-five cases of healthy physical examination in our hospital were selected as a healthy control group.Patients with active pulmonary tuberculosis were treated with 2H3R3Z3E3/4H3R3 or 2HRZE/4HR standard regimen.The expression of miR-155-5p,miR-21-5p,miR-29a and miR-142-5p were detected by qRT-PCR. Results miR-155-5p,miR-21-5p and miR-29a in the active tuberculosis group were significantly higher than those in the healthy control group and other lung disease control group(P<0.05).MiR-155-5p,miR-21-5p and miR-29a in the other lung disease control groups were significantly higher than those in the healthy control group(P<0.05).However,there was no significant difference in the expression of miR-142-5p between the three groups(P>0.05).MiR-155-5p,miR-21-5p and miR-29a were significantly decreased in patients with active tuberculosis after standardized anti-tuberculosis treatment(P<0.05).The expression of miR-142-5p was not statistically significant before and after treatment(P>0.05).The miR-155-5p,miR-21-5p and miR-29a have good diagnostic significance,sensitivity and specificity for active pulmonary tuberculosis by ROC curve analysis. Conclusion miR-155-5p,miR-21-5p and miR-29a can be used as a useful marker for the evaluation of anti-tuberculosis efficacy in the course of treatment of active pulmonary tuberculosis.