高同型半胱氨酸血症对桡动脉-头静脉内瘘成形术后血流量的影响  

Effect of hyperhomocysteinemia on blood flow after radial artery-cephalic vein fistula angioplasty

作　　者：陈超 吴义强 CHEN Chao;WU Yi-qiang(Jieyang People's Hospital,Jieyang 522000,China)

机构地区：[1]揭阳市人民医院,522000

出　　处：《中国实用医药》2021年第10期49-51,共3页China Practical Medicine

基　　金：2019年度揭阳市医学科研项目立项。

摘　　要：目的探究高同型半胱氨酸血症对桡动脉-头静脉内瘘成形术后血流量的影响。方法 60例高同型半胱氨酸血症的慢性肾脏病5期行动静脉造瘘术的患者为研究对象,其中, 20例血浆同型半胱氨酸浓度为16~20μmol/L(A组), 20例血浆同型半胱氨酸浓度为21~25μmol/L(B组), 20例血浆同型半胱氨酸浓度为26~30μmol/L(C组)。检测并比较三组桡动脉及头静脉内膜钙化情况,动静脉内瘘血流量。结果 A组轻度钙化17例,重度钙化3例;B组轻度钙化14例,重度钙化6例;C组轻度钙化7例,重度钙化13例。C组重度钙化率高于A组及B组,差异具有统计学意义(P<0.05);A组与B组的重度钙化率比较,差异无统计学意义(P>0.05)。A组动静脉内瘘血流量为(590.35±56.47)ml/min,B组动静脉内瘘血流量为(553.36±57.82)ml/min, C组动静脉内瘘血流量为(508.25±53.62)ml/min。C组动静脉内瘘血流量小于A组及B组, B组动静脉内瘘血流量小于A组,差异具有统计学意义(P<0.05)。结论血浆同型半胱氨酸水平越高,桡动脉、头静脉内膜增厚及钙化程度越严重,动静脉内瘘成形术后血流量越小。Objective To investigate the effect of hyperhomocysteinemia on blood flow after radial artery-cephalic vein fistula angioplasty. Methods There were 60 patients with stage 5 chronic kidney disease hyperhomocysteinemia undergoing arteriovenous fistuloplasty as study subjects, including 20 patients with plasma homocysteine concentrations of 16-20 μmol/L(group A), 20 patients with plasma homocysteine concentrations of 21-25 μmol/L(group B), and 20 patients with plasma homocysteine concentrations of 26-30 μmol/L(group C). The intimal calcification of radial artery and cephalic vein and blood flow of arteriovenous fistula were detected and compared among the three groups. Results There were 17 cases of mild calcification and 3 cases of severe calcification in group A;14 cases of mild calcification and 6 cases of severe calcification in group B;7 cases of mild calcification and 13 cases of severe calcification in group C. The severe calcification rate of group C was higher than that of group A and group B, and the difference was statistically significant(P<0.05). There was no statistically significant difference in severe calcification rate between group A and group B(P>0.05). The blood flow of arteriovenous fistula of group A was(590.35±56.47) ml/min, which was(553.36±57.82) ml/min of group B and(508.25±53.62) ml/min of group C. The blood flow of arteriovenous fistula in group C was less than that in group A and group B, and that in group B was less than that in group A, and the difference was statistically significant(P< 0.05). Conclusion The higher the plasma homocysteine level, the more serious the intimal thickening and calcification of radial artery and cephalic vein, and the lower the blood flow after arteriovenous fistuloplasty.

关 键 词：高同型半胱氨酸血症 桡动脉 头静脉 内瘘成形术 血流量 

分 类 号：R692[医药卫生—泌尿科学] R589.7[医药卫生—外科学]