实用器官移植电子杂志

实用器官移植电子杂志 ›› 2025, Vol. 13 ›› Issue (6): 507-513.DOI: 10.3969/j.issn.2095-5332.2025.06.005

• 论著 • 上一篇    下一篇

肾移植受者肺部感染影响因素分析及预测模型构建

姚伟1，庄梦洁1，张洁1，马月蕾1，丁贞艳1，张本艳1，王云超2，张晓明2，王建宁2   

  1. 1. 山东第一医科大学第一附属医院（山东省千佛山医院）护理学，山东 济南 250014；

    2. 山东第一医科大学第一附属医院（山东省千佛山医院）泌尿外科学，山东省肾脏病研究所，山东 济南 250014 

  • 出版日期:2025-11-20 发布日期:2025-11-20
  • 基金资助:

    国家自然科学基金（82373042）; 

    国家卫健委卫生科技发展研究中心（WKZX2024CX401204）; 

    山东省自然科学基金（ZR2024QH293）；

    山东省公共卫生学会（SDPHA202429）；

    山东省研究型医院协会（2022021）；

    泰山学者青年专家（NO.tsqn202312356）；

    济南市科学技术局（202134064） 

Analysis of the influencing factors of pulmonary infection in kidney transplant recipients and the construction of prediction model 

Yao Wei1  ，Zhuang Mengjie 1 ，Zhang Jie 1 ，Ma Yuelei 1 ，Ding Zhenyan 1 ，Zhang Benyan 1 ，Wang Yunchao 2 ，Zhang Xiaoming 2 ，Wang Jianning 2 .    

  1. 1.Department of Nursing，The First Affiliated Hospital of Shandong First Medical University，Shandong Provincial Qianfoshan Hospital，Shandong Jinan 250014，China；

    2.Department ofUrology，TheFirstAffiliatedHospital of ShandongFirstMedicalUniversity,ShandongProvincialQianfoshanHospital，Shandong Institute ofNephrology，Shandong Jinan 250014，China.

  • Online:2025-11-20 Published:2025-11-20

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摘要：

目的 探讨影响肾移植受者肺部感染的生理和心理因素，构建风险预测模型。 方法 回顾性分析山东省千佛山医院 2019 年 1 月至 2024 年 1 月行肾移植术的 327 例受者的临床及随访资料，依据肾移植术后 1 年内是否发生肺部感染分为肺感染组（102 例）和非肺感染组（225 例），收集数据，进行多因素回归分析，构建肾移植受者肺部感染的预测模型，应用受试者工作特征（receiver operating characteristic，ROC）曲线验证其预测价值。 结果 肾移植术后 1 年内肺部感染率为 31.19%，年龄增长、术前血糖高、睡眠障碍、使用环孢素及吗替麦考酚酯为肺部感染的独立危险因素，术后第 5 天血白细胞计数和积极心理资本为独立保护性因素（P ＜ 0.05）；构建的肾移植受者肺部感染风险预测模型方程的曲线下面积（area under curve，AUC）为 88.7%，Kappa 值为 0.66（P ＜ 0.05）。 结论 基于生理因素和心理因素构建的肾移植受者肺部感染预测模型具有较好的预测价值。

关键词: 肾脏移植 , 肺部感染 , 积极心理品质 , 睡眠质量 , 危险因素 , 风险预测模型

Abstract:

Objective To explore the physiological and psychological factors affecting pulmonary infection in kidney transplant recipients and to construct a risk prediction model. Methods The clinical and follow-updata of 327 recipients undergoing kidney transplantation in Shandong Provincial Qianfoshan Hospital from January2019 to January 2024 were retrospectively analyzed. The recipients were divided into pulmonary infection group（102 cases）and non-pulmonary infection group（225 cases）according to whether pulmonary infection occurred after kidney transplantation. The data of the two groups of recipients was analyzed with multivariate regression analyze，theprediction model of pulmonary infection of kidney transplant recipients was constructed，and the receiver operatingcharacteristic（ROC）curve was used to verify the predictive value. Results The rate of pulmonary infection within 1 years after kidney transplantation was 31.19%. Age，blood glucose，insomnia severe index，use of cyclosporine and mycophenolate mofetil were independent risk factors for pulmonary infection. While white blood cell count on postoperative day 5 and positive psychological capital were independent protective factors（P ＜ 0.05）.The areaunder curve（AUC）of the constructed model equation for predicting the risk of pulmonary infection was 88.7% with a Kappa value of 0.66（P ＜ 0.05）. Conclusion The prediction model of pulmonary infection in kidney transplant recipients constructed based on physiological and psychological factors has a good predictive value. 

Key words:

">  , Kidney transplantation； Pulmonary infection； Positive psychological quality； Sleep quality； Riskfactors； Risk prediction model

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