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目的 总结肾移植术后肺炎患者的临床特点,对影响其预后的相关因素进行生存分析.方法 纳入2014年1月1日至2015年12月31日期间在四川省人民医院因肺炎住院的肾移植术后患者89例,采集患者的J临床资料,通过Kaplan-Meier法计算总体生存率(OS)并绘制生存曲线,比较不同因素对预后的影响,采用Cox回归模型分析多种因素对生存的影响.结果 肾移植术后肺炎发生时间集中在移植术后6个月内,主要表现包括干咳(95.5％)、发热(56.1％)和呼吸困难(12.3％).肾移植术后肺炎病死率11.2％,死亡集中在移植术后5个月内.Kaplan-Meier分析显示C反应蛋白(CRP) ≤40 mg/L组较CRP＜40 mg/L组的OS下降(P＜0.001),降钙素原(PCT)≥1 ng/ml组较PCT＜1 ng/ml组的OS下降(P=0.002),血小板计数(Plt)≤100×l09/L组较Plt＞ 100× 109/L组的OS下降(P＜0.001),脑钠肽(BNP) ＞100 pg/ml组较BNP≤100 pg/ml组的OS下降(P＜0.001),肺炎发生时间＜移植术后180 d组较≥移植术后180 d组的OS下降(P=0.013).Cox回归模型分析显示Plt≤100×109/L时死亡风险增加66.6倍(RR=0.015,P=0.006);CRP≥40 mg/L时死亡风险增加20倍(RR=0.05,P=0.029).结论 肾移植术后肺炎的发生发展、症状、体征、病原学、影像具有突出的临床特点.当Plt≤100× 109/L或CRP≥40 mg/L时,肾移植术后肺炎患者的死亡风险明显增加,可作为评估病情严重程度的独立危险因素.“,”Objective To analyze the clinical characteristics and related prognostic factors of post-renal transplantation pneumonia.Methods The clinical data of 89 patients with post-renal transplantation pneumonia in Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital from 1st January 2014 to 31st December 2015 were collected in the study.Kaplan-Meier method was used to calculate overall survival.Cox analysis was used to analyze the related prognostic factors.Results Post-renal transplantation pneumonia occurred mainly within 6 months after renal transplantation.The prominent clinical manifestations were cough (95.5％),fever (56.1％),and dyspnea (12.3％).The mortality of post-renal transplantation pneumonia was 11.2％ and all death occurred within 5 months after transplantation.The overall survival rate significantly decreased in the patients with C-reactive protein (CRP) ≥40 mg/L (P＜0.001),procalcitonin ≥1 ng/ml (P=0.002),brain natriuretic peptide ＞100 pg/ml (P＜0.001),platelet ≤100×109/L (P＜0.001),or those with occurrence time of pneumonia ＜ 180 days (P=0.013).Platelet ≤ 100× 109/L could increase the risk of death by 66.6 times (RR=0.015,P=0.006),and CRP ≥ 40 mg/L could increase the risk of death by 20 times (RR=0.05,P=0.029).Conclusions Post-renal transplantation pneumonia has prominent clinical characteristics.Platelet ≤100×109/L or CRP ≥40 mg/L can increase the risk of death and can be used as an independent prognoctic factor of postrenal transplatation pneumonia.