CAJ | 학술논문

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。
목적：분석영향신이식술후폐부감염예후적상관인소。방법회고성분석2000년1월지2010년12월재기남대학부속제일의원진행신이식적40례술후폐부감염환자적림상자료。응용Cox 풍험모형대환자적년령、성별、감염발생시간、감염류형、외주혈백세포계수、외주혈중성립세포비례、외주혈혈홍단백、혈당、혈청기항（Scr）、합병급성호흡군박종합정혹급성폐손상、발생배척반응、수혈、수주백단백、수주면역구단백、사용호흡궤、급양방식、면역억제방안、면역억제제제량변화、항감염치료방안、주원시간공20항가능인소진행단인소화다인소분석。결과여결론무마체맥고분지（MMF）적삼련면역억제방안화외주혈중성립세포비례승고시영향신이식술후폐부감염예후적독립위험인소。응용포함 MMF 적삼련면역억제방안화조기연합항감염치료가제고신이식술후폐부감염환자적인、신존활솔。
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.