肾移植术后重症肺炎患者的预后危险因素

Prognostic risk factors of patients with severe pneumonia after kidney transplantation

目的探讨肾移植术后重症肺炎患者的预后危险因素。方法收集2015年1月1日至2021年11月31日入住郑州大学第一附属医院重症监护病房的肾移植术后重症肺炎患者的病例资料,采用单因素分析、Logistic回归分析及ROC曲线等方法对其临床资料进行统计学分析。结果共有96例患者纳入研究,根据其出院转归分为存活组60例和死亡组36例。其中存活组男48例,女12例,年龄(37.1±13.77)岁;死亡组男31例,女5例,年龄(40.64±15.28)岁。两组研究对象之间,性别、年龄比较无统计学差异(P>0.05)。两组间降钙素原、D-二聚体、尿素、肌酐、肾小球滤过率、CD_(4)^(+)T淋巴细胞计数存在统计学意义(P均<0.05)。Logistic回归及ROC曲线提示APACHE II评分(AUC 0.733)、D-二聚体(AUC 0.702)、CD_(4)^(+)T淋巴细胞(AUC 0.638)对于肾移植后重症肺炎患者的预后均具有一定价值。结论应关注肾移植后重症肺炎患者的免疫状态改善和出凝血功能,尤其是APACHE II评分高的患者。

Objective To explore the prognostic risk factors of severe pneumonia after renal transplantation.Methods It collected the clinical data of kidney transplant recipients with severe pneumonia admitted to the intensive care unit of the First Affiliated Hospital of Zhengzhou University from January 1,2015,to November 31,2021.The clinical data were statistically analyzed by univariate analysis,Logistic regression analysis,and ROC curve.Results A total of 96 patients were included in the study.According to their discharge outcome,they were divided into 60 cases in the survival group and 36 cases in the non-survival group.There were 48 males and 12 females in the survival group,whose average age was(37.1±13.77)years old.There were 31 males and 5 females in the non-survival group with an average age of(40.64±15.28)years old.There was no significant difference in gender and age between the two groups(P>0.05).APACHE II score(AUC 0.733),D-Dimer(AUC 0.702),and CD_(4)^(+) T lymphocytes(AUC 0.638)were of certain value in the prognosis of kidney transplant recipients with severe pneumonia.Conclusion Attention should be paid to the immune status and coagulation function of patients with severe pneumonia after kidney transplantation,especially those with high APACHE II scores.