肾移植术后肺部感染预后的Cox风险模型分析

李文浩; 苏泽轩; 叶泽兵; 黄明坦; 陈航

doi:10.3969/j.issn.1674-7445.2015.03.010

肾移植术后肺部感染预后的Cox风险模型分析

doi: 10.3969/j.issn.1674-7445.2015.03.010

510317 广州, 广东省第二人民医院急诊科(李文浩、叶泽兵、黄明坦、陈航)；暨南大学附属第一医院泌尿外科科(苏泽轩)

基金项目:

广东省临床重点专科建设项目粤卫函[2012]994号

详细信息

通讯作者:
李文浩,Email:liwenhao0712@126.com

中图分类号: R617
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- 被引次数: 0
出版历程
- 收稿日期: 2015-03-11
- 网络出版日期: 2021-01-19
- 刊出日期: 2015-05-15

Analysis on prognosis of pulmonary infection after renal transplantation by Cox risk model

Department of Emergency, Guangdong No.2 Provincial People's Hospital, Guangzhou 510317, China

More Information

Corresponding author: Li Wenhao, Email: liwenhao0712@126.com

摘要

摘要: 目的分析影响肾移植术后肺部感染预后的相关因素。方法回顾性分析2000年1月至2010年12月在暨南大学附属第一医院进行肾移植的40例术后肺部感染患者的临床资料。应用Cox风险模型对患者的年龄、性别、感染发生时间、感染类型、外周血白细胞计数、外周血中性粒细胞比例、外周血血红蛋白、血糖、血清肌酐(Scr)、合并急性呼吸窘迫综合征或急性肺损伤、发生排斥反应、输血、输注白蛋白、输注免疫球蛋白、使用呼吸机、给氧方式、免疫抑制方案、免疫抑制剂剂量变化、抗感染治疗方案、住院时间共20项可能因素进行单因素和多因素分析。 结果与结论 无吗替麦考酚酯(MMF)的三联免疫抑制方案和外周血中性粒细胞比例升高是影响肾移植术后肺部感染预后的独立危险因素。应用包含MMF的三联免疫抑制方案和早期联合抗感染治疗可提高肾移植术后肺部感染患者的人、肾存活率。
- 肾移植 /
- 肺部感染 /
- 预后 /
- Cox风险模型
Abstract: Objective To analyze the relevant factors affecting prognosis of pulmonary infection after renal transplantation. Methods The clinical data of 40 patients who suffered from pulmonary infection after renal transplantation at the First Affiliated Hospital of Jinan University from January 2000 to December 2010 were analyzed retrospectively. By Cox risk model, single and multi-analysis were performed on 20 possible factors, including age, gender, time of infection, type of infection, white blood cell count, neutrophil ratio, hemoglobin, blood glucose, serum creatinine (Scr), pulmonary infection complicated with acute respiratory distress syndrome or acute pulmonary injury, rejection, blood transfusion, infusion of albumin, infusion of immune globulin, use of ventilator, way of offering oxygen, immunosuppressive regimen, dosage change of immunosuppressant, anti-infection therapeutic regimen and length of stay. Results and Conclusions Triple immunosuppressive therapy without mycophenolate mofetil (MMF) and increase of neutrophil ratio were independent risk factors for pulmonary infection after renal transplantation. Triple immunosuppressive therapy with MMF combined with early anti-infection therapeutic regimen may improve patient and graft survival of patients with pulmonary infection after renal transplantation.
- Renal transplantation /
- Pulmonary infection /
- Prognosis /
- Cox risk model

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表 1 肾移植术后肺部感染患者预后的Cox风险模型单因素分析结果

Table 1. Single factor analysis on prognosis of patients with pulmonary infection after renal transplantation by Cox risk model

因素	偏回归系数	偏回归系数的标准误	Wald χ²值	P值	RR	RR 95%CI
免疫抑制方案			6.532	0.038
CsA+MMF+Pred	-1.856	0.904	4.216	0.040	0.156	(0.027, 0.919)
FK506+MMF+Pred	-2.647	1.042	6.457	0.011	0.071	(0.009, 0.546)
外周血中性粒细胞比例	0.158	0.075	4.415	0.036	1.171	(1.011, 1.357)
血糖	0.183	0.087	4.473	0.034	1.201	(1.014, 1.423)
注：免疫抑制方案以无MMF免疫抑制方案为参照组；RR为相对危险度(relative risk)；CI为可信区间(confidence interval)

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表 2 肾移植术后肺部感染患者预后的Cox风险模型多因素分析结果

Table 2. Multi-factor analysis on prognosis of patients with pulmonary infection after renal transplantation by Cox risk model

因素	偏回归系数	偏回归系数的标准误	Wald χ²值	P值	RR	RR 95%CI
免疫抑制方案			5.809	0.055
CsA+MMF+Pred	-1.918	0.944	4.129	0.042	0.147	(0.023, 0.934)
FK506+MMF+Pred	-2.543	1.068	5.667	0.017	0.079	(0.010, 0.638)
外周血中性粒细胞比例	0.176	0.088	3.951	0.047	1.192	(1.002, 1.418)
注：免疫抑制方案以无MMF免疫抑制方案为参照组；RR为相对危险度(relative risk)；CI为可信区间(confidence interval)

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