Abstract:

Objective To explore the risk factors of invasive pulmonary aspergillosis （IPA） after organ transplantation and establish a Nomogram risk prediction model. Methods A total of 612 patients undergoing organ transplantation admitted to Hebei Yanda Hospital from January 2018 to January 2024 were randomly divided into training set （n ＝ 408） and verification set （n ＝ 204）. The patients in the training set were divided into IPA group （n ＝ 29） and non-IPA group （n ＝ 349） according to whether they had concurrent IPA or not. Factors of IPA were analyzed， and a Nomogram model was established and verified. Results The incidence of IPA was7.76%. Age， diabetes， chronic obstructive pulmonary disease， bronchitis， antibiotic usage time and invasive mechanical ventilation were independent risk factors for IPA after organ transplantation （OR ＝ 3.438，3.743， 3.219，3.149，3.747，3.053，P ＜ 0.05）， and immunosuppresant dose adjustment was its protective factor （OR ＝0.556，P ＜ 0.05）. Based on the above factors， a Nomogram model was established to predict the IPA after organtransplantation， the model showed good discrimination and ideal predictive performance， and net benefits could be obtained. Conclusion Age， diabetes， chronic obstructive pulmonary disease， bronchitis， antibiotic usage time andinvasive mechanical ventilation are independent risk factors for IPA after organ transplantation， and immunosuppresant dose adjustment is its protective factor. The Nomogram model constructed based on this has good predictive performance. 

Key words:

"> Organ transplantation,  , Invasive pulmonary aspergillosis,  , Nomogram model

摘要：

目的 探究器官移植术后并发侵袭性肺曲霉病（invasive pulmonary aspergillosis，IPA）的风险因素并构建 Nomogram 风险预测模型。 方法 选取 2018 年 1 月至 2024 年 1 月河北燕达医院收治的 612 例行器官移植术的患者，分为训练集（n ＝ 408）和验证集（n ＝ 204）。将训练集患者根据是否并发 IPA 分为IPA 组（n ＝ 29）和非 IPA 组（n ＝ 349），分析影响并发 IPA 的风险因素，构建 Nomogram 模型并验证。 结果 IPA 发生率为 7.76%。年龄、有糖尿病、有慢性阻塞性肺疾病、有支气管炎、使用抗菌药物时间、使用有创机械通气均是器官移植术后并发 IPA 的独立危险因素（OR ＝ 3.438、3.743、3.219、3.149、3.747、3.053，P ＜ 0.05），免疫抑制剂量调整是其保护因素（OR ＝ 0.556，P ＜ 0.05）。基于以上因素建立了预测器官移植术后并发 IPA 的 Nomogram 模型，其区分度和预测效能理想，且可获得净收益。 结论 年龄、有糖尿病、有慢性阻塞性肺疾病、有支气管炎、使用抗菌药物时间、使用有创机械通气是器官移植术后并发 IPA 的危险因素，免疫抑制剂量调整是其保护因素，以此构建的 Nomogram 模型具有良好的预测效能。

关键词:

器官移植 , 侵袭性肺曲霉病 ,  , Nomogram 模型