Analysis of Risk Factors for Restenosis after Interventional Treatment of Tuberculous Airway Stenosis.

Abstract

Introduction: Airway stenosis is the most common and serious complication of tracheobronchial tuberculosis (TBTB). Systemic anti-tuberculosis treatment is the basic treatment for TBTB airway stenosis, and supplemented with tracheoscopic intervention, it can effectively minimize the occurrence of TBTB stenosis or reduce the degree of stenosis; however, some patients still have restenosis after the intervention. However, some patients still have restenosis after intervention.

Methods: We retrospectively collected the clinical data of patients diagnosed with tuberculous airway stenosis in the Second Hospital of Lanzhou University and Lanzhou Pulmonary Hospital from January 2021 to June 2023. The patients were divided into the restenosis group and the non-restenosis group according to whether or not restenosis occurred in the airway within 1 year of the intervention, and the differences in the clinical data between the two groups were compared, and the variables with statistically significant differences in the univariate analysis were analyzed by multifactorial binary logistic regression.

Results: A total of 154 patients with tuberculous airway stenosis were included in this study, including 64 patients in the restenosis group, and the restenosis rate was 41.6%. Univariate analysis showed that the systemic immune inflammation index (SII) was higher in the restenosis group than in the non-restenosis group, and the composition of diabetic patients, stenosis length >3 cm, and positive antacid staining of tracheal secretions were higher in the restenosis group than in the non-restenosis group (all p < 0.05). The composition of microscopically inactive, anti-tuberculosis treatment before intervention and balloon dilatation was lower (all p < 0.05). Multifactorial binary logistic regression analysis showed that diabetes (OR = 5.758, 95% CI: 1.434-23.119), stenosis length (OR = 6.349, 95% CI: 2.653-15.197), SII (OR = 1.002, 95% CI: 1.001-1.003), anti-tuberculosis treatment before interventional therapy (OR = 0.250, 95% CI: 0.084-0.746), and TBTB microscopic classification and staging (OR = 0.306, 95% CI: 0.099-0.941) were independent influencing factors of restenosis after interventional therapy for tuberculous airway stenosis.

Conclusion: Diabetes, stenosis length >3 cm, and high SII were independent risk factors for restenosis after intervention for tuberculous airway stenosis, before interventional anti-tuberculosis treatment and microscopic inactivity were independent protective factors.