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公民逝世后器官捐献供肾肾移植术后肺部感染风险因素分析

张朋朋 明英姿

张朋朋, 明英姿. 公民逝世后器官捐献供肾肾移植术后肺部感染风险因素分析[J]. 器官移植, 2016, 7(3): 205-209. doi: 10.3969/j.issn.1674-7445.2016.03.009
引用本文: 张朋朋, 明英姿. 公民逝世后器官捐献供肾肾移植术后肺部感染风险因素分析[J]. 器官移植, 2016, 7(3): 205-209. doi: 10.3969/j.issn.1674-7445.2016.03.009
Zhang Pengpeng, Ming Yingzi. Analysis on risk factors of pulmonary infection after renal transplantation from organ donation after citizen's death[J]. ORGAN TRANSPLANTATION, 2016, 7(3): 205-209. doi: 10.3969/j.issn.1674-7445.2016.03.009
Citation: Zhang Pengpeng, Ming Yingzi. Analysis on risk factors of pulmonary infection after renal transplantation from organ donation after citizen's death[J]. ORGAN TRANSPLANTATION, 2016, 7(3): 205-209. doi: 10.3969/j.issn.1674-7445.2016.03.009

公民逝世后器官捐献供肾肾移植术后肺部感染风险因素分析

doi: 10.3969/j.issn.1674-7445.2016.03.009
详细信息
    通讯作者:

    明英姿,Email:myz_china@aliyun.com

  • 中图分类号: R617, R563

Analysis on risk factors of pulmonary infection after renal transplantation from organ donation after citizen's death

More Information
  • 摘要:   目的  探讨公民逝世后器官捐献供肾肾移植术后受者发生肺部感染的影响因素。   方法  回顾性分析中南大学湘雅三医院器官移植中心自2010年4月至2014年12月公民逝世后器官捐献供肾肾移植125例供者与210例受者的临床资料。根据移植术后有否发生肺部感染将受者分为肺部感染组(37例)和无肺部感染组(173例)。了解肺部感染受者的一般情况和预后。对供者因素(性别、年龄、维持治疗时间、感染史)、受者因素[性别、年龄、吸烟史、糖尿病史,术前血红蛋白、白细胞、中性粒细胞百分比、白蛋白、血清肌酐等水平,术后有否急性排斥反应、有否使用生物制剂、有否预防性应用更昔洛韦及复方磺胺甲噁唑(SMZ)]进行单因素分析和多因素Logistic回归分析,找出肺部感染的独立危险因素。   结果与结论  37例肺部感染患者中,8例发展为重症肺部感染死亡。公民逝世后器官捐献供肾肾移植术后受者发生肺部感染的独立危险因素包括供体维持治疗时间、有感染史,受体吸烟史、糖尿病史、无预防性应用更昔洛韦或SMZ。

     

  • 表  1  肾移植术后肺部感染的单因素分析结果

    Table  1.   Single factor analysis results of pulmonary infection after renal transplantation

    影响因素 肺部感染组 非肺部感染组 P
    供体
     性别(男/女) 17/14 48/46 0.074
     年龄(岁) 41±8 43±10 0.753
     维持治疗时间(d) 15±5 9±4 < 0.001
     感染史(有/否) 22/9 20/74 < 0.001
    受体
     性别(男/女) 20/17 114/59 0.064
     年龄(岁) 35±10 35±10 0.069
     吸烟史(有/否) 25/12 22/151 < 0.0001
     糖尿病史(有/否) 7/30 3/170 < 0.0001
     术前血红蛋白(g/L) 88±11 89±11 0.276
     术前白细胞(×109/L) 7.0±0.3 6.0±0.4 0.067
     术前中性粒细胞百分比 0.74±0.09 0.70±0.08 0.081
     术前白蛋白(g/L) 30±5 30±5 0.579
     术前血清肌酐(μmol/L) 1 024±512 964±486 0.283
     术后急性排斥反应(有/否) 21/16 24/149 < 0.001
     术后使用生物制剂(有/否) 20/17 17/156 < 0.001
     术后预防性应用更昔洛韦(有/否) 12/25 150/23 < 0.001
     术后预防性应用SMZ(有/否) 19/18 127/46 0.034
    下载: 导出CSV

    表  2  肾移植术后肺部感染的多因素分析结果

    Table  2.   Multiple factors analysis results of pulmonary infection after renal transplantation

    相关因素 回归系数 比值比 95%可信区间 P
    供体维持治疗时间 2.128 10.047 3.127~54.124 0.001
    供体感染史 2.432 10.493 2.342~46.417 0.042
    受体吸烟史 1.846 7.543 1.467~35.714 0.009
    受体糖尿病史 2.169 9.137 1.971~35.312 0.035
    受体无预防性应用更昔洛韦 2.013 5.218 1.147~33.785 < 0.001
    受体无预防性应用SMZ 2.248 14.231 3.498~55.993 0.032
    下载: 导出CSV
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出版历程
  • 收稿日期:  2016-03-09
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2016-05-15

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