摘要
目的分析肾移植与肝移植术后肺部感染的异同点,探讨有效诊治措施。方法对2004年1月至2008年12月间发生肺部感染的肾移植受者及肝移植受者进行回顾性分析,比较两组受者肺部感染的特点。结果肾移植组肺部感染45例,肝移植组肺部感染23例,其肺部感染发生率分别分7.4%vs56.1%(P<0.001),重症肺炎发生率2.6%vs46.3%(P<0.001),肺炎诊断距移植中位时间(d)230(29-1080)vs4(2-104)(P<0.001),肺炎病死率6.7%vs17.4%(P=NS),肺部感染导致移植受者的死亡率0.5%vs9.8%(P<0.001);两组细菌性感染的病原菌均以G-菌为主,但肝移植组受者多重耐药菌的比例较高(12.9%vs37.0%,P=0.005)。结论了解肾移植及肝移植术后肺部感染的规律,能够为移植术后预防性抗感染治疗以及感染早期的经验性治疗提供依据,减少感染患者的死亡率及提高移植受者的存活率。
Objective To summarize the features of pulmonary infection （PI） in kidney transplant （Ktx） and liver transplant （Ltx） recipients for effective control measures. Methods A retrospective analysis was conducted among Ktx recipients and Ltx recipients with PI during the period from Jan 2004 to Dec 2008. The clinical data concerning the infection was compared. Results Forty-five Ktx recipients and 23 Ltx recipients developed PI after the transplantation. The incidence of PI was 7.4% and 56.1% in （P0.001）, respectively, with severe PI occurring in 2.6% and 46.3% of the recipients （P0.001）. The median time from PI diagnosis to transplant was 230 days （29-1080 days） and 4 days （2-104 days） （P0.001）, the case-fatality rate for PI was 6.7% and 17.4% （P=NS）, and the mortality rate was 0.5% and 9.8% （P0.001） in Ktx and Ltx recipients, respectively; Gram-negative organisms were the most common in both Ktx and Ltx recipients, but Ltx recipients had significantly higher incidence of multidrug-resistant bacteria （12.9% vs 37.0% , P=0.005）. Conclusion The knowledge of PI after the transplantation will benefit appropriate prophylactic and empirical treatment to improve the survival of Ktx and Ltx recipients.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2010年第7期1679-1681,共3页
Journal of Southern Medical University
关键词
肾移植
肝移植
肺部感染
kidney transplantation
liver transplantation
pulmonary infections
