实用器官移植电子杂志

实用器官移植电子杂志 ›› 2025, Vol. 13 ›› Issue (1): 7-11.DOI: 10.3969/j.issn.2095-5332.2025.01.002

• 论著 • 上一篇    下一篇

老年肾移植术后反复肺炎的危险因素分析

刘炎忠 1 ，李超 2 ，董红梅 2 ，陈昌庆 2    

  1. 1. 解放军总医院第三医学中心，北京 100089 

    2. 解放军总医院第八医学中心，北京 100091 

  • 出版日期:2025-01-20 发布日期:2025-01-20
  • 基金资助:

    解放军总医院青年自主创新科学基金项目（22QNFC045） 

Analysis of risk factors for recurrent pneumonia in elderly kidney transplant recipients after surgery 

Liu Yanzhong1 ，Li Chao2 ，Dong Hongmei2 ，Chen Changqing2 .    

  1. 1.The Third Medical Center of the People's Liberation Army General Hospital，Beijing 100089；

    2.The Eighth Medical Center of the People's Liberation Army General Hospital，Beijing 100091，China.

  • Online:2025-01-20 Published:2025-01-20

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摘要：

目的 探讨老年肾移植受者术后反复（≥ 2 次）发生肺炎的危险因素。方法 回顾性分析解放军总医院第八医学中心自 2010 年 1 月至 2024 年 1 月之间行肾移植手术的 119 例老年受者的临床资料。根据肾移植术后是否反复（≥ 2 次）发生肺炎将老年受者分为两组，其中反复肺炎组有 11 例，非反复肺炎组有 108 例。通过分析比较两组的相关临床资料，包括受者一般基本信息，如性别、年龄、身高、体重、有无吸烟史等，以及相关临床资料，如肾移植术前透析时间、术后免疫抑制剂维持治疗方案、是否出现移植肾功能延迟恢复、移植术后白细胞是否减少、出院时血清肌酐水平、是否接受过静脉激素冲击治疗、手术前后是否有糖尿病以及是否有乙型病毒性肝炎感染等，进行单因素分析和多因素 Logistic 回归分析，分析探讨老年肾移植受者术后反复肺炎的危险因素。结果 老年肾移植受者术后反复肺炎发生率为 9.24%（11/119），反复肺炎组中有 1 例发生重症肺炎而死亡，病死率为 9.1%（1/11），吸烟史（OR ＝ 13.15，95% CI ＝ 2.406 ～ 71.91，P ＝ 0.003）和术后白细胞减少（OR ＝ 6.050，95% CI ＝ 1.248 ～ 29.32，P ＝ 0.025）是老年肾移植受者术后反复肺炎的危险因素。结论 有吸烟史和术后白细胞减少会增加老年肾移植受者术后反复肺炎的风险，应加强对老年肾移植受者术后健康宣教，鼓励戒烟，以及加强术后白细胞减少症的防治。

关键词:

肾移植 , 感染 , 危险因素 , 反复肺炎

Abstract:

Objective To explore the risk factors for recurrent （≥ 2 times） pneumonia in elderlykidney transplant recipients after surgery. Methods Retrospective analysis was performed from the clinical data of 119 elderly kidney transplant recipients who underwent kidney transplantation at the Eighth Medical Center of the People's Liberation Army General Hospital from January 2010 to January 2024. According to whether pneumonia occurs repeatedly （≥ 2 times） after kidney transplantation， elderly recipients were divided into two groups， with 11 cases in the recurrent pneumonia group and 108 cases in the non-recurrent pneumonia group. Relevant clinical data were compared between the two groups， including the general basic information of the recipient （gender， age， height， weight， smoking history，etc.）， as well as the relevant clinical data （the time of dialysis before kidney transplantation， the maintenance treatment plan of immunosuppressant after surgery， whether there was delayed recovery of kidney function after transplantation， whether there was a decrease in white blood cells after transplantation， serum creatinine level at discharge， whether there was diabetes before and after surgery， and whether there was viral hepatitis B infection， etc.）. We conducted univariate analysis and multivariate logistic regression analysis to explore the risk factors for recurrent pneumonia in elderly kidneytransplant recipients after surgery. Results The incidence of recurrent pneumonia in elderly kidney transplant recipientsafter surgery was 9.24% （11/119）， and one patient in the case group died from severe pneumonia， with a mortality rate of 9.1% （1/11）. Smoking history （OR ＝ 13.15，95% CI ＝ 2.406 ～ 71.91，P ＝ 0.003） and postoperative leukopenia （OR ＝ 6.050，95% CI ＝ 1.248 ～ 29.32，P ＝ 0.025） were risk factors for recurrent pneumonia in elderly kidney transplant recipients. Conclusion Smoking history and postoperative leukopenia increase the risk of recurrent pneumonia in elderly kidney transplant recipients. So we should strengthen postoperative health education for elderly kidney transplant recipients， encourage smoking cessation， and prevent and treat postoperative leukopenia. 

Key words:

Kidney transplantation,  , Infection,  , Risk factors,  , Recurrent pneumonia

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