肾移植术后巨细胞病毒肺炎发生急性呼吸窘迫综合征危险因素分析

摘要

Objective To analyse the clinical characteristics of renal transplant recipients with cytomegalovirus pneumonia and to explore the risk factors of acute respiratory distress syndrome(ARDS)in these patients. Methods A retrospective study were carred out to collect the clinical characteristics of renal transplant recipients with cytomegalovirus pneumonia and analyse the relationship between these clinical factors and ARDS. Results 76 cases of renal transplant recipients with cytomegalovirus pneumonia were enrolled from May 2004 to March 2010, in which 32 (42.11％ ) patients generated ARDS; Logistic Regression showed that renal transplant recipients who got cytomegalovirus pneumonia in the early stage,diabetes,history of rejection reaction, broad extent of pneumonia had higher incidence of ARDS, while strengthening blood glucose management and early treatment using corticosteroids lead to a lower incidence of ARDS. Conclusion Cytomegalovirus pneumonia in the early stage, diabetes, history of rejection reaction,broad extent of pneumonia constituted the high risk factors of ARDS in renal transplant recipients with cytomegalovirus pneumonia while strengthening blood glucose management and early treatment using corticosteroids would be protective factors.%目的 探讨肾移植术后巨细胞病毒(CMV)肺炎患者发生急性呼吸窘迫综合征(ARDS)的危险因素,以采取有效预防控制措施.方法 采用回顾性观察方法,收集我院肾移植术后巨细胞病毒肺炎患者的病例资料,分析各项临床因素与发生ARDS的关系.结果 我院2004年5月-2010年3月期间肾移植术后发生巨细胞病毒肺炎共76例,其中32例发生ARDS,发生率为42.11%;采用Logistic回归分析发现,肾移植术后发生巨细胞病毒肺炎时间早、合并糖尿病、发生过排斥反应、炎症病变范围广等因素使ARDs发生率增高,严格控制血糖、早期使用激素治疗可使ARDS发生率降低.结论 肾移植术后早期发生巨细胞病毒肺炎、合并糖尿病、发生过排斥反应、炎症病变范围广等是肾移植术后巨细胞病毒肺炎发生ARDS的高危因素;严格控制血糖、早期使用激素治疗则是保护因素.