腹膜透析患者肺部感染危险因素及其预测模型构建  

Risk factors for pulmonary infection in peritoneal dialysis patients and establishment of prediction model

作　　者：许春香[1] 储虹[1] 崔英[1] 汪湜[1] XU Chun-xiang;CHU Hong;CUI Ying;WANG Shi(Yixing People's Hospital,Yiring,Jiangsu 214200,China)

机构地区：[1]宜兴市人民医院肾内科,江苏宜兴214200

出　　处：《中华医院感染学杂志》2024年第1期37-40,共4页Chinese Journal of Nosocomiology

基　　金：江苏省卫生健康委科研课题(Z2018011)。

摘　　要：目的探究腹膜透析患者发生肺部感染的危险因素,并构建预测模型,分析其预测价值。方法194例2019年10月-2022年10月宜兴市人民医院收治的腹膜透析患者,依据是否伴肺部感染分为感染组34例和未感染组160例,收集患者痰液样本进行病原学检查,多因素Logistic回归分析腹膜透析患者发生肺部感染的危险因素,并建立预测模型,绘制受试者工作特征(ROC)曲线评估模型的预测价值。结果腹膜透析患者肺部感染的发生率为17.53%(34/194);共分离出42株病原菌,包括革兰阳性菌8株占19.05%,革兰阴性菌30株占71.43%,真菌4株占9.52%;透析龄≥60个月、住院次数≥3次是腹膜透析患者发生肺部感染的危险因素(P<0.05),据筛选的危险因素构建的预测模型为:Logit(P)=-10.382+透析龄≥60个月×0.617+住院次数≥3次×0.783,该预测概率P的曲线下面积(AUC)值为0.914。结论腹膜透析患者肺部感染发生率较高,以革兰阴性菌感染为主,且透析龄长、住院次数多是腹膜透析患者发生肺部感染的危险因素,据此构建的预测模型具有较好的预测价值。OBJECTIVE To explore the risk factors for pulmonary infection in the peritoneal dialysis patients,es-tablish the prediction model and analyze its predictive value.METHODS A total of 194 peritoneal dialysis patients who were treated in Yixing People's Hospital from Oct 2019 to Oct 2022 were enrolled in the study and were di-vided into the infection group with 34 cases and the no infection group with 160 cases according to the status of pulmonary infection.Sputum specimens were collected to carry out etiological examination.Multivariate logistic regression analysis was performed for the risk factors for the pulmonary infection in the peritoneal dialysis pa-tients,the prediction model was established,and the predictive value of the model was analyzed by means of re-ceiver operating characteristic(ROC)curves.RESULTS The incidence of pulmonary infection was 17.53%(34/194)among the peritoneal dialysis patients.Totally 42 strains of pathogens were isolated,8(19.05%)of which were gram-positive bacteria,30(71.43%)were gram-negative bacteria,and 4(9.52%)were fungi.No less than 60 months of dialysis and no less than 3 times of hospital stay were the risk factors for the pulmonary infection in the peritoneal dialysis patients(P<0.05).The prediction model that was established based on the screened risk factors was as follows:Logit(P)=-10.382+no less than 60 months of dialysis×0.617+no less than 3 times of hospital stay×0.783.The area under curve(AUC)of the prediction probability was 0.914.CONCLUSION The incidence of pulmonary infection is high among the peritoneal dialysis patients.The gram-negative bacteria are dominant among the pathogens.Long time period of dialysis and large number of times of hospital stay are the risk factors for the pulmonary infection.The prediction model that is established based on the risk factors has high predictive value.

关 键 词：腹膜透析 肺部感染 病原菌 危险因素 受试者工作特征 

分 类 号：R692.5[医药卫生—泌尿科学]