动静脉内瘘超声参数与内瘘功能不良的相关性研究

发布时间：2018-03-28 21:22

本文选题：动静脉内瘘　切入点：功能不良　出处：《肾脏病与透析肾移植杂志》2017年05期

【摘要】：目的:分析维持性血液透析(MHD)患者动静脉内瘘(AVF)的超声参数特征及其与AVF功能不良之间的关系。方法:采集以AVF为透析通路的MHD患者临床信息,于非透析日行超声检查,监测血流动力学参数及评估AVF并发症情况。结果:将患者按内瘘功能分为功能良好组(115例)和功能不良组(29例),两组平均肱动脉流量分别为1 150.62±63.6 ml/min及803.84±108.91 ml/min(P0.05),桡动脉流量分别为765.82±34.97ml/min及478.57±67.36 ml/min(P0.01),肱动脉阻力指数(RI)分别为0.48±0.01及0.55±0.03(P0.01),桡动脉RI分别为0.35±0.01及0.39±0.02(P0.05),将肱动脉和桡动脉的RI、流量、瘘口直径分别按四分位法进行分组,统计各组内瘘功能不良发生率,发现当肱动脉流量641.3 ml/min、桡动脉流量428.3 ml/min、桡动脉RI0.41、瘘口直径0.39 cm时,AVF功能不良发生率显著升高。结论:本研究证实AVF超声参数与其功能之间具有良好的相关性,内瘘超声检查可为AVF功能不良早期实施干预措施提供依据和参考。
[Abstract]:Objective: to analyze the characteristics of ultrasonic parameters of arteriovenous fistula (AVF) in patients with maintenance hemodialysis (HD) and its relationship with AVF dysfunction. Methods: the clinical information of MHD patients with AVF as dialysis pathway was collected and examined by ultrasonography on the day of non-dialysis. Hemodynamic parameters were monitored and AVF complications were evaluated. Results: according to the function of internal fistula, the patients were divided into two groups: the well-functioning group (n = 115) and the dysfunctional group (n = 29). The mean brachial artery flow was 1 150.62 卤63.6 ml/min and 803.84 卤108.91 ml / min, P 0.05, radial artery, respectively. The flow rate was 765.82 卤34.97ml/min and 478.57 卤67.36ml / min, the brachial artery resistance index (RI) was 0.48 卤0.01,0.55 卤0.03, and the RI of radial artery was 0.35 卤0.01and 0.39 卤0.02p0.05. the RI of brachial artery and radial artery were measured. The diameter of fistula was divided into groups according to quartile method, and the incidence of dysfunctional fistula in each group was counted. It was found that when brachial artery flow was 641.3 ml / min, radial artery flow was 428.3 ml / min, radial artery RI was 0.41 and fistula diameter was 0.39cm, the incidence of AVF dysfunction was significantly increased. Conclusion: there is a good correlation between AVF ultrasonic parameters and its function. Ultrasound examination of internal fistula can provide basis and reference for early intervention of AVF dysfunction.
【作者单位】：东南大学附属中大医院肾脏科;
【基金】：国家自然科学基金(81570612);国家自然科学基金(81370826) 江苏省临床医学科技专项(BL2014080) 江苏省十二五医学重点人才项目(RC2011124)
【分类号】：R459.5

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