肾移植患者重症肺部感染预后的多因素分析

Multiple factor analysis on prognasis of severe lung infection in patients with renal transplantation

目的 :分析影响肾移植术后重症肺部感染患者预后的相关因素 ,找出影响生存时间的主要因素 ,为临床治疗提供参考。方法 :回顾 46例肾移植术后重症肺部感染患者的临床资料 ,分析 PRA、感染发生时间、免疫抑制方案、抗感染治疗方案等 9项相关因素 ,应用 Cox比例风险模型检验各因素与肺部感染患者生存时间的关系。结果 :术后发生感染时间、预防性应用更昔洛韦、应用 OKT3及抗感染治疗方案是影响肾移植术后肺部感染患者预后的 4个主要因素 ,各种口服免疫抑制剂方案对预后的影响无显著性差异。结论 :预防性应用更昔洛韦和≥ 3种联合抗感染治疗是影响肾移植术后重症肺部感染患者预后的保护因素 ,感染发生时间和应用

Objective:To analyse the influence of related factors on the prognosis of patients with lung infection after the renal transplantation and probe into a main factor affected the survival time,and provide data for the clinical treatment.Methods:Clinical data of 40 cases with lung infection after the renal transplantation were reviewed.Nine related factors,such as the occurrance time of infection scheme on immunosuppression,plan on antiinfections treatment,etc.were analysed,and the relationship between vavious factors and the survival time in patients with lung infection was examined according to Cox proportional risk model.Results:The occurrance time of infection after the operation,Preveative use of ganciclovir application of OKT 3 and antiinfections treatment were four main factors for affecting prognosis of patients with lung infection after the renal transplatation.There was no significant difference for prognosis among various schemes on oral immunosuppression.Conclusion:Preventive use of ganciclovir and combined antiinfections treatment (more than three medicines)are protective factor for the pregnosis of patients with severe lung infection after the renal transplatation,but the occurrancetiace of infection and use of OKT 3 are risk factors.