肱动脉多普勒超声对血液透析自体动静脉内瘘的诊断价值  

Value of ultrasound in detecting brachial artery in diagnosis of autohemodialysis arteriovenous fistula

作　　者：徐涛[1] 宁春平[1] 周茂平[1] 孙艺华 周涵霄 王宏桥[1] XU Tao;NING Chunping;ZHOU Maoping;SUN Yihua;ZHOU Hanxiao;WANG Hongqiao(Department of Abdominal Ultrasound,the Affiliated Hospital of Qingdao University,Shangdong 266103,China)

机构地区：[1]青岛大学附属医院腹部超声科

出　　处：《临床超声医学杂志》2019年第12期891-894,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81501477)

摘　　要：目的应用超声检测肱动脉多普勒参数评估自体动静脉内瘘的功能。方法将102例患者按血液透析期间泵血流量正常、泵血流量减少分为功能正常组66例、功能障碍组36例,应用多普勒超声测量肱动脉的血流量、阻力指数(RI)及搏动指数(PI),比较两组肱动脉相关参数的差异;绘制受试者工作特征(ROC)曲线,分析肱动脉相关参数预测自体动静脉内瘘结局的诊断效能。结果功能正常组与功能障碍组肱动脉血流量、RI、PI比较差异均有统计学意义(均P<0.05);肱动脉血流量、RI、PI预测结局的截断值分别为455 ml/min、0.53、0.82,ROC曲线下面积分别为0.747、0.807、0.977,敏感性分别为55.56%、55.56%、86.11%,特异性分别为90.91%、93.94%、100%。结论肱动脉血流量、RI、PI等多普勒参数可为血液透析患者自体动静脉内瘘功能提供有价值的信息,其中肱动脉PI预测价值更高。ObjectiveTo evaluate the function of autologous arteriovenous internal fistula by ultrasonic Dopplerparameters of brachial artery.MethodsOne hundred and two patients were divided into functional group(n=66)and functionaldisorder group(n=36)according to the normal pump blood flow and decreased pump blood flow during hemodialysis.The bloodflow(BF),resistance index(RI)and pulsatile index(PI)of brachial artery were measured by Doppler ultrasound,and theparameters of the two groups were compared.The diagnostic efficacy of brachial artery related parameters in predicting theoutcome of autologous arteriovenous fistula was analyzed by receiver operating characteristic(ROC)curve.Results Thedifference of brachial artery BF,RI and PI between the functional group and functional disorder group was statistically significant(all P<0.05).The cut-off values of brachial artery BF,RI and PI predicted outcomes were 455 ml/min,0.53 and 0.82,respectively.The area under the ROC curve were 0.747,0.807 and 0.977,respectively.The sensitivity were 55.56%,55.56%,86.11%,and the specificity were 90.91%,93.94%,100%,respectively.ConclusionDoppler parameters such as brachial arteryBF,RI,PI can provide valuable information for the function of autologous arteriovenous internal fistula in hemodialysis patients,among which brachial artery PI has a higher predictive value.

关 键 词：超声检查 自体动静脉内瘘 肱动脉 血流量 阻力指数 搏动指数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R459.5[医药卫生—诊断学]