CAJ | 학술논문

目的探讨肝移植术后巨细胞病毒(CMV)感染的危险因素.方法回顾性分析2004年1月至2008年12月在北京朝阳医院肝胆外科行肝移植手术并随访3个月的182例患者的临床资料,其中男性146例,女性36例,平均年龄(50±7)岁.按术后是否有CMV感染分为感染组(n=24)和对照组(n=158).应用Logistic回归分析探讨围手术期CMV感染的危险因素.结果经单因素分析结果提示,急性肝功能衰竭(P =0.032)、MELD评分≥30分(P =0.001)、再次肝移植(P=0.002)、急性排斥反应(P =0.000)、移植肝功能恢复延迟(P =0.022)是肝移植术后CMV感染的危险因素.依据多因素分析结果显示,MELD评分≥30分(P =0.037,95％ CI:1.194 ～ 271.461)和急性排斥反应(P=0.033,95％ CI:1.179 ～51.863)是肝移植术后CMV感染的独立危险因素.结论 MELD评分≥30分和急性排斥反应是CMV感染的独立危险因素.
목적 탐토간이식술후거세포병독(CMV)감염적위험인소.방법 회고성분석2004년1월지2008년12월재북경조양의원간담외과행간이식수술병수방3개월적182례환자적림상자료,기중남성146례,녀성36례,평균년령(50±7)세.안술후시부유CMV감염분위감염조(n=24)화대조조(n=158).응용Logistic회귀분석탐토위수술기CMV감염적위험인소.결과 경단인소분석결과제시,급성간공능쇠갈(P =0.032)、MELD평분≥30분(P =0.001)、재차간이식(P=0.002)、급성배척반응(P =0.000)、이식간공능회복연지(P =0.022)시간이식술후CMV감염적위험인소.의거다인소분석결과현시,MELD평분≥30분(P =0.037,95％ CI:1.194 ～ 271.461)화급성배척반응(P=0.033,95％ CI:1.179 ～51.863)시간이식술후CMV감염적독립위험인소.결론 MELD평분≥30분화급성배척반응시CMV감염적독립위험인소.
Objective To investigate the clinical predictors of cytomegalovirus (CMV) infection after liver transplantation.Methods The clinical data of 182 patients(146 male and 36 female with a mean age of (50 ± 7)years) receiving liver transplantation in Beijing Chaoyang Hospital between January 2004 and December 2008 were retrospectively analyzed.All patients were divided into two groups,namely the CMV infection group(n =24) and the control group (n =158).Logistic regression was used to identify the predictive factors of postoperative CMV infection.Results According to univariate analysis results,the factors for CMV infection were acute liver failure (P =0.032),MELD score ≥ 30 (P =0.001),liver retransplantation(P =0.002),acute rejection (P =0.000) and delayed graft function (P =0.022).According to multi-analysis results,MELD score ≥ 30 (P =0.037,95％ CI:1.194-271.461) and acute rejection(P =0.033,95％ CI:1.179-51.863) were proved to be independent predictors by multivariate analysis.Conclusion The study indicates that MELD score ≥ 30 and acute rejection are the independent predictors of CMV infection.