肾移植患者血流感染死亡的危险因素分析  

Analysis of the risk factors for death in patients with bloodstream infections after renal transplantation

作　　者：蒋欣[1] 曲青山[1] 李明[1] 邢利[1] 苗书斋[1] 

机构地区：[1]南方医科大学附属郑州人民医院肾病中心,河南郑州450003

出　　处：《中华医院感染学杂志》2014年第15期3753-3754,3772,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(豫卫科[2011]16)

摘　　要：目的探讨肾移植患者血流感染死亡的危险因素,为临床评估患者预后和预防血流感染的发生提供依据。方法回顾性分析自2002年6月-2013年6月接受肾移植发生血流感染的217例患者临床资料,通过自制的调查表格收集患者的一般信息、临床资料和相关的实验室检查结果,建立数据库后通过单因素分析和多因素分析探讨肾移植患者并发血流感染死亡危险因素,数据采用SPSS 17.0进行分析。结果肾移植发生血流感染有78.80%为医院感染;29.95%不规范使用抗菌药物;217例患者中死亡72例,病死率为33.18%;原发疾病主要为慢性肾小球肾炎,占66.82%;多因素分析结果显示,感染性休克、血小板计数<50×109/L是肾移植术后并发血流感染的独立死亡危险因素。结论感染性休克和血小板计数<50×109/L是肾移植患者并发血流感染的独立死亡危险因素,临床上应做好预防措施,尽量避免血流感染的发生,降低肾移植患者的病死率。OBJECTIVE To investigate the risk factors for death in patients with bloodstream infections after renal transplantation, to provide the basis for prevention of bloodstream infections and clinical evaluation of patient prognosis. METHODS The clinical data of 217 patients with bloodstream infections after renal transplantation were retrospectively analyzed. The general information, clinical data and related laboratory results of the patients were collected through the self-made survey form. The risk factors for death were analyzed by single factor analysis and multi factor analysis with the establishment of database. Data were analyzed by SPSS 17.0. RESULTS Totally 78.80 % of bloodstream infections after renal transplantation was nosocomial infections, 29.95 % were due to nonstandard use of antibiotics. There were 72 cases of death in the 217 patients, the mortality was 33.18%. The main type of primary disease was chronic glomerulonephritis （66.82%）. The multivariate analysis showed that septic shock and platelet count 〈50×10^9/L were the independent risk factors for death in patients with blood- stream infections after renal transplantation. CONCLUSION Septic shock and platelet count 〈50 × 10^9/L are independent risk factors for death in patients with bloodstream infection after renal transplantation, the clinical prevention measures should be adopted, as soon as possible to avoid blood infection and reduce mortality in patients with renal transplantation.

关 键 词：肾移植 血流感染 死亡 危险因素 

分 类 号：R181.32[医药卫生—流行病学]