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

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