血清全段甲状旁腺激素水平对自体动静脉内瘘成熟的影响  

The effect of serum intact parathyroid hormone level on the maturation of autogeneous arteriovenous fistula

作　　者：汪朋瑞 陈华茜[1] 杨涛[1] 赵黎[1] 李蓬[2] Wang Pengrui;Chen Huaqian;Yang Tao;Zhao Li;Li Peng(Nephrology Department,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan 442008,China;Ultrasonic Department,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan 442008,China)

机构地区：[1]湖北医药学院附属国药东风总医院肾脏内科,湖北十堰442008 [2]湖北医药学院附属国药东风总医院超声科,湖北十堰442008

出　　处：《临床荟萃》2022年第12期1094-1098,共5页Clinical Focus

摘　　要：目的探讨慢性肾衰竭(chronic renal failure,CRF)患者血清全段甲状旁腺激素(intact parathyroid hormone,iPTH)水平对自体动静脉内瘘(autogeneous arteriovenous fistule,AVF)成熟的影响。方法选取2019年1月至2022年5月于国药东风总医院肾脏内科住院并行AVF成形术患者108例,收集患者AVF成形术前一般资料、各项生化指标、双上肢动静脉彩色超声及术后2月桡动脉-头静脉瘘彩色超声。依据内瘘成熟情况分为AVF成熟组与AVF成熟不良组,分析两组术前一般资料、各项生化指标及影像学资料对AVF成熟的影响。结果与AVF成熟不良组比较,AVF成熟组年龄较小、合并糖尿病占比较少、使用钙离子拮抗剂占比较少,血清iPTH、高敏C反应蛋白水平较低,头静脉内径较大,差异均有统计学意义(P<0.05)。多因素Logistc回归分析显示,年龄、高敏C反应蛋白、头静脉内径均是影响AVF成熟的独立危险因素(均P<0.05)。结论年龄、高敏C反应蛋白、头静脉内径均是AVF成熟的独立危险因素。iPTH水平升高与AVF成熟不良相关。Objective To investigate the effect of serum intact parathyroid hormone(iPTH)level on the maturation of autogeneous arteriovenous fistula(AVF)in patients with chronic renal failure(CRF).Methods A total of 108 patients treated with AVF angioplasty in the Nephrology Department of Sinopharm Dongfeng General Hospital from January 2019 to May 2022 were recruited.Their baseline characteristics,biochemical data,color ultrasound reports of arteries and veins of both upper limbs and those of radial artery cephalic vein fistula at 2 months postoperatively were collected.Patients were assigned into AVF maturation group and AVF malmaturation group.The influence of clinical data on the maturation of AVF was analyzed.Results Compared with patients in the AVF malmaturation group,patients in the AVF maturation group were significantly younger,and the incidence of diabetes was significantly lower(P<0.05).Moreover,the use of calcium antagonists was significantly less frequent(P<0.05).Serum iPTH and high-sensitivity C-reactive protein were significantly lower in the AVF maturation group(P<0.05).The diameter of cephalic vein was significantly larger than that of AVF malmaturation group(P<0.05).Multivariate Logistic regression analysis showed that age,high-sensitivity C-reactive protein and head vein diameter were independent risk factors for AVF maturation(all P<0.05).Conclusion Age,high sensitivity C-reactive protein and head vein diameter are independent risk factors for AVF maturation.Elevated iPTH levels are associated with poor AVF maturation.

关 键 词：肾功能衰竭 慢性 血清全段甲状旁腺激素 自体动静脉内瘘 

分 类 号：R692.5[医药卫生—泌尿科学]