Pei Yu-Zhen 1Yan Hong-Qian 1Nie Jia 1Yu Xiang-Yan 1Liu Xin-Fa 1Kang Zeng-Lu 1Su Ying-Hao1
作者信息
- 1. Department of Respiratory and Critical Care Medicine,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050000,China
- 折叠
摘要
Abstract
Objective To explore the changes in airway microbiota and their impact on restenosis risk in patients with severe airway stenosis after bronchoscopy intervention therapy.Methods A retrospective study was conducted on 513 patients with severe airway stenosis who underwent bronchoscope-guided interventional treatment at Hebei Hospital of Traditional Chinese Medicine from March 2019 to May 2024.Based on the presence or absence of airway restenosis 3 months after treatment,the patients were divided into restenosis group(n=134)and control group(n=379).High-throughput sequencing of 16S rRNA gene sequences was performed on sputum samples from patients with airway stenosis to observe the overall composition and diversity characteristics of their airway microbial communities.Logistic regression analysis was used to analyze the relationship between airway microbiota and pulmonary function indices,as well as inflammatory indices.Stratified interaction tests were conducted to analyze the relationship between airway restenosis and microbiota under different treatment methods.A multivariate Cox proportional hazards regression model was utilized to analyze the risk factors for recurrence within 3 months in patients with severe airway stenosis.The interaction and types of effects between airway microbiota and inflammatory indices on restenosis in patients with severe airway stenosis were analyzed using an interaction calculation table.Results The proportion of stent implantation,underlying diseases,local infections,and the area of scar lesions in restenosis group were significantly higher than those in control group(P<0.05).After treatment,compared with control group,the forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),FEV1/FVC,Chao index,Ace index,and Shannon index in restenosis group were significantly lower,while the levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-10,C-reactive protein(CRP),and Simpson index were significantly higher(P<0.05).Compared with the pre-treatment data in the same group,all indices in both groups showed significant improvements after treatment(P<0.001).There was a statistically significant difference in the β diversity of airway flora between the two groups after treatment(P=0.001).Compared with control group,the relative abundances of Proteobacteria and Actinobacteria in the airway microbiota of the restenosis group were significantly increased,while the relative abundances of Bacteroidetes and Fusobacteria were significantly decreased(P<0.05).After treatment,Chao index,Ace index,and Shannon index were positively correlated with pulmonary function indices and negatively correlated with inflammatory indices;Simpson index was negatively correlated with pulmonary function indices and positively correlated with inflammatory indices(P<0.05).Stratified interaction tests showed that the treatment method had no significant impact on the relationship between airway restenosis and microbiota.Stent implantation,underlying diseases,local infections,increased area of scar lesions,and elevated post-treatment Simpson index,IL-6,and CRP were independent risk factors for recurrence within 3 months in patients with severe airway stenosis(P<0.05).Elevated post-treatment Chao index,Ace index,Shannon index were protective factors against recurrence within 3 months(P<0.05).No significant collinearity was found among the factors.During the occurrence of restenosis in patients with severe airway stenosis,there were significant interactions between the post-treatment airway microbiota indices(Chao index,Ace index,Shannon index,Simpson index)and inflammatory indices such as IL-6 and CRP levels(P<0.001).Conclusions Among alpha diversity indicators of airway flora,elevated post-treatment Simpson index are independent risk factors for recurrence within 3 months in patients with severe airway stenosis,while elevated post-treatment Chao index,Ace index,and Shannon index are protective factors against recurrence within 3 months.After treatment,the alpha diversity of airway flora in patients is positively correlated with pulmonary function indices and negatively correlated with inflammatory indices.关键词
严重气道狭窄/支气管镜/气道微生态/再狭窄Key words
severe airway stenosis/bronchoscopy/airway microbiota/narrowing again分类
医药卫生
