肾移植术后感染巨细胞病毒性肺炎的多因素分析  

Multivariate analysis of the risk factors of cytomegalovirus pneumonia after renal transplantation

作　　者：魏强[1] 于立新[1] 邓文锋[1] 叶俊生[1] 

机构地区：[1]南方医科大学南方医院器官移植科,广东广州50515

出　　处：《南方医科大学学报》2009年第6期1182-1184,共3页Journal of Southern Medical University

基　　金：广东省自然科学基金(7300389)

摘　　要：目的探讨肾移植术后感染巨细胞病毒性(CMV)肺炎的多种高危因素,提出早期预防措施。方法回顾2005年1月～2007年12月间曾在我院接受同种异体肾脏移植术并因发生CMV肺炎而再次入院患者28例,采用卡方检验及多元logistic回归分析方法分别对影响CMV肺炎的一些因素进行逐步分析。结果与CMV肺炎感染密切相关的独立因素包括:受者年龄、急性排斥反应、术前透析时间、移植肾功能延迟恢复、受者PRA水平、供体CMV血清学、麦考酚酸酯的应用;logistic回归分析认为供体CMV血清学IgG(+)、术后急性排斥反应及术前长期血透时间为高危因素。结论肾移植术后为减少巨细胞病毒性肺炎的发生发展,抑制早期急性排斥反应非常重要,同时尽量选择血清学阴性供体,缩短肾移植术前血透时间也能减少其发病率。Objective To identify the risk factors for cytomegalovirus （CMV） pneumonia after renal transplantation and investigate the early precaution measures. Methods A retrospective study was conducted in a group of 28 patients undergoing renal transplantation who were readmitted because of CMV pneumonia between Jan, 2005 and Dec, 2007. Chi-square test and multivariate logistic regression were used to identity the significant risk factors. Results Seven factors, namely recipient age, acute graft rejection, pre-transplantation dialysis, delayed graft function recovery, recipient peak PRA level, donor CMV positivity and the use of MMF were found to significantly correlate to post-transplant CMV pneumonia. Multivariate logistic regression further confirmed that donor CMV IgG positivity, acute graft rejection and pre-transplantation dialysis for over 6 months were independent factors to predict the occurrence of CMV pneumonia. Conclusion Acute graft rejection control, appropriate donor selection and shortened dialysis before the transplantation can be crucial factors to reduce the incidence of CMV pneumonia after renal transplantation.

关 键 词：巨细胞病毒性肺炎 肾移植/并发症 病毒感染 

分 类 号：R699.2[医药卫生—泌尿科学] R563.1[医药卫生—外科学]