肺移植术后肺部细菌感染的危险因素及其对死亡风险的影响分析-东南大学学报医学版

肺移植术后肺部细菌感染的危险因素及其对死亡风险的影响分析

单位：南京医科大学附属无锡人民医院/南京医科大学无锡医学中心肺移植中心, 江苏无锡 214023

分类号：R655.3; R563.1

出版年·卷·期（页码）：2023·42·第三期（348-356）

摘要：

目的: 探讨肺移植术后肺部细菌感染的危险因素及其对死亡风险的影响。方法: 回顾性分析南京医科大学附属无锡人民医院2019年1月至2020年12月期间行肺移植手术的274例患者的临床资料,采用单因素及多因素二分类非条件Logistic回归探索肺部细菌感染的影响因素,通过Kaplan-Meier法和Cox回归分析肺部细菌感染对死亡风险的影响。结果: 供肺细菌感染(OR=2.859,95%CI 1.202~6.801)和受者术前肺部细菌感染(OR=2.812,95%CI 1.043~7.576)是术后肺部细菌感染的潜在危险因素。术后肺部细菌感染者短期死亡风险较未感染者低,但随着时间的推移,其死亡风险逐渐增加,而未感染者趋于平稳(HR=1.628,95%CI 0.816~3.249)。结论: 供肺细菌感染和受者术前肺部细菌感染是肺移植术后早期肺部细菌感染的危险因素,但尚未观察到术后早期肺部细菌感染对1年死亡风险具有显著影响。

Objective: To explore the risk factors of pulmonary bacterial infection after lung transplantation and its effect on the risk of death. Methods: Clinical data of 274 patients who underwent lung transplantation in Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2019 to December 2020 were retrospectively analyzed. Univariate and multivariate binary Logistic regression were used to explore the influencing factors of pulmonary bacterial infection.Kaplan-Meier method and Cox regression were used to analyze the effect of pulmonary bacterial infection on the risk of death. Results: Bacterial infection of donor lung(OR=2.859, 95%CI 1.202-6.801) and preoperative bacterial infection of recipient lung(OR=2.812, 95%CI 1.043-7.576) were potential risk factors for postoperative bacterial infection of lung.The short-term mortality risk of patients with pulmonary bacterial infection after surgery was lower than that of patients without pulmonary bacterial infection. However, as time went on, the mortality risk of patients with pulmonary bacterial infection increased gradually, while that of patients without pulmonary bacterial infection tended to be stable(HR=1.628, 95%CI 0.816-3.249). Conclusion: Bacterial infection of donor lung and preoperative bacterial infection of recipient lung are risk factors for early pulmonary bacterial infection after lung transplantation, but it has not been observed that early postoperative pulmonary bacterial infection has a significant effect on the 1-year mortality risk.

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