Objective: To explore the influencing factors for postoperative survival of patients with pneumoconiosis (silicosis) after lung transplantation in order to improve their clinical outcomes. Methods: In August 2021, retrospective alalysis from December 2015 to July 2021, 29 patients with end-stage pneumoconiosis underwent lung transplantation at Department of Thoracic Surgery, Affiliated Henan Provincial People's Hospital, Zhengzhou University. The survival, postoperative complications, and causes of death were analyzed. Life table and Kaplan-Meier method were used to draw survival curves, the log-rank test was used to compare the influence of each factor on survival rates, and the multivariate Cox proportional hazards regression model was used to evaluate the influence of each factor on survival. Results: All the patients underwent successful lung transplantation, with survival rates of 75% at 6 months, 70% at 1 year, 65% at 2 years, 50% at 3 years and 50% at 5 years. The Kaplan-Meier survival analysis showed that BMI, age and preoperative albumin level were influencing factors for postoperative survival rates (P<0.05) . The multivariate COX regression model showed that BMI≥18.5 kg/m(2) and the albumin level≥35 g/L were the protective factors (P<0.05) . Conclusion: Aging older, preoperative BMI<18.5 kg/m(2) and hypoalbuminemia are independent risk factors for death after lung transplantation. Survival rates are affected by preoperative BMI index, albumin level and age. Early intervention should be made before lung transplantation to promote the BMI index and albumin level to reach the standard.
目的： 探讨尘（矽）肺患者肺移植术后影响预后的因素，以改善其临床结局。 方法： 于2021年8月，回顾性分析2015年12月至2021年7月符合纳入标准的29例男性尘（矽）肺行肺移植术患者的基线数据和随访资料，分析其存活情况、术后并发症及死亡原因。用寿命表法和Kaplan Meier法绘制生存曲线观察不同阶段的累积生存率，并进行依时COX多因素风险回归模型分析评估各因素对临床预后的影响。 结果： 尘（矽）肺患者肺移植术后6个月、术后1年、2年、3年、5年的累积生存率分别是75%、70%、65%、50%、50%；肺移植患者术前体质指数（BMI）≥18.5 kg/m(2)组的中位生存时间为40月，BMI<18.5 kg/m(2)组的中位生存时间为25月，两组间比较差异有统计学意义（P=0.019）；与年龄≥45岁组比较，年龄<45岁组患者累计生产率更高，差异有统计学意义（P=0.022）。COX比例风险回归模型多因素分析显示，BMI指数≥18.5 kg/m(2)和白蛋白≥35 g/L是肺移植术后生存的保护性因素（P=0.031，0.007），年龄增长是肺移植术后死亡的独立危险因素（P=0.006）。 结论： 年龄增长、术前BMI指数<18.5 kg/m(2)和低蛋白血症可能会影响肺移植术后患者生存时间，肺移植术前应及早干预营养不良，促使患者BMI指数和血清白蛋白水平达标。.
Keywords: Lung transplantation; Pneumoconiosis; Risk factors; Survival rates.