束臂后头静脉直径和扩张性对腕部桡动脉-头静脉内瘘成熟的预测价值及影响因素分析  

The value and influencing factors of cephalic vein diameter and cephalic vein dilatation behind bundle arm in predicting the maturity of carpal radial-cephalic arteriovenous fistula

作　　者：王华 梁辑 詹元英 郑颖来 王雁 Wang Hua;Liang Ji;Zhan Yuanying;Zheng Yinglai;Wang Yan(Hemodialysis Room,Haikou Third People's Hospital,Hainan 571100,Haikou,China)

机构地区：[1]海口市第三人民医院血透室,海南海口571100

出　　处：《血管与腔内血管外科杂志》2021年第1期71-75,共5页Journal of Vascular and Endovascular Surgery

基　　金：海南省自然科学基金(820MS165)。

摘　　要：目的探讨束臂后头静脉直径和扩张性对腕部桡动脉-头静脉内瘘(RC-AVF)成熟的预测价值及影响因素分析。方法选取海口市第三人民医院2017年3月至2020年1月80例建立RC-AVF的终末期肾病患者,根据术后6周患者建立RC-AVF后成熟情况分为成熟组(n=58)和未成熟组(n=22);比较两组患者的束臂后头静脉直径和扩张性;采用受试者工作特征(ROC)曲线确定束臂后头静脉直径、扩张性单独或联合对RC-AVF成熟的预测价值,采用多因素Logistic回归分析RC-AVF成熟的影响因素。结果成熟组患者束臂后头静脉直径及扩张性均大于未成熟组患者,差异有统计学意义(P<0.05);预测RC-AVF成熟,束臂后头静脉直径截断点为2.61 mm,灵敏度和特异度分别为78.49%和75.20%;束臂后头静脉扩张性截断点为0.58 mm,灵敏度和特异度分别为84.29%和61.39%;二者联合应用的灵敏度和特异度为91.77%和81.86%。腕桡动脉直径>2.10 mm、束臂后头静脉直径>2.61 mm、束臂后头静脉扩张性>0.58 mm均是RC-AVF成熟的保护因素(P<0.05)。结论束臂后头静脉直径及扩张性对RC-AVF成熟具有较高的诊断价值;束臂后头静脉直径>2.61 mm、头静脉扩张性达>0.58 mm均是RC-AVF成熟的保护因素。Objective To explore the value and influencing factors of the diameter and dilatation of the cephalic vein behind the arm in predicting the maturation of the wrist radial-cephalic arteriovenous fistula(RC-AVF). Method The clinical data of 80 patients with RC-AVF established in Haikou Third People Hospital the cephalic vein behind the arm in predicting the matur. The patients were divided into mature group(n=58) and immature group(n=22) according to their maturity of RC-AVF establishment after 6 weeks. The diameter and dilatation of the cephalic vein behind the arm were compared between the two groups. Receiver operating characteristic(ROC) was used to determine the diameter and dilatation of the cephalic vein after the arm and the combined application to predict the value of RC-AVF maturity. Multivariate Logistic regression was used to analyze the influencing factors of RC-AVF maturity. Result The diameter and dilatability of the cephalic vein behind the arm in the mature group were larger than those in the immature group, and the difference was statistically significant(P<0.05). It is predicted that the RC-AVF is mature, the cut-off point of the diameter of the cephalic vein behind the beam arm is 2.61 mm, and the sensitivity and specificity are 78.49% and 75.20%, respectively. The expansive cut-off point of the cephalic vein behind the beam arm is 0.58 mm, and the sensitivity and specificity are 84.29% and 61.39%, respectively. The sensitivity and specificity of the combined application of the two are 91.77% and 81.86%. The diameter of the radial carpal artery>2.10 mm,the diameter of the cephalic vein> 2.61 mm, brachial posterior cephalic vein dilation>0.58 mm were protective factors for RC-AVF maturation(P<0.05). Conclusion The combined application of the diameter and dilatation of the cephalic vein behind the arm has a high diagnostic value for the maturation of RC-AVF. The diameter of the cephalic vein behind the arm is more than 2.61 mm and the dilatation of the cephalic vein is more than 0.58 mm are protec

关 键 词：头静脉直径 头静脉扩张性 桡动脉-头静脉内瘘 成熟 

分 类 号：R543[医药卫生—心血管疾病]