彩色多普勒超声肱动脉血流量/肱动脉阻力指数评价动静脉内瘘狭窄的价值  

Value of color Doppler ultrasound for brachial artery flow/brachial artery resistance index to evaluate internal arteriovenous fistula stenosis

作　　者：闫博 岳庆雄 YAN Bo;YUE Qing-xiong(Department of Ultrasound,Dalian Municipal Central Hospital,Dalian 116011,China)

机构地区：[1]大连理工大学附属大连市中心医院超声诊断科,大连116011

出　　处：《中国血液净化》2023年第4期302-305,共4页Chinese Journal of Blood Purification

摘　　要：目的 应用彩色多普勒超声探讨肱动脉血流量(blood flow volume,Qa)/阻力指数(resistance index,RI)评价动静脉内瘘狭窄的价值。方法 回顾性分析2020年1月~2021年9月在大连理工大学附属大连市中心医院肾内科透析的患者,根据超声测量静脉内径,<2mm为狭窄组(n=75),≥2mm为正常组(n=109),记录超声测量指标Qa、RI、Qx(肱动脉血流量/阻力指数,Qx=Qa/RI)及性别、年龄、体质量指数(body mass index,BMI)、是否患有糖尿病、是否吸烟等。结果 狭窄组和正常组在性别(t=1.400,P=0.270)、BMI(χ^(2)=9.105,P=0.448)、是否吸烟(t=0.043P,=0.834)的差异没有统计学意义。正常组和狭窄组比较在糖尿病(t=0.059,P<0.001)、Qa(χ^(2)=42.868,P<0.001)、RI(χ^(2)=42.823,P<0.001)、Qx(χ^(2)=40.919,P<0.001)差异有统计学意义。Logistic回归分析结果显示Qx是诊断内瘘狭窄的有效指标(OR=0.997,95%CI:0.995~0.998,P<0.001)。ROC曲线结果显示:Qx与Qa没有显著差异,Qx与RI有显著差异(AUC Qa-Qx,P=0.071,AUC Qx-RI,P<0.001)。结论 Qx是评估内瘘狭窄的有效指标,结合Qa和RI可以有效诊断内瘘狭窄。Objective The resistance index(RI)and blood flow volume(Qa)are two important Doppler ultrasound parameters to identify the stenosis in arteriovenous fistula(AVF).In this study,we aimed to evaluate the diagnostic capability of Qa/RI(Qx)for the early identification of AVF stenosis.Methods A total of 184 hemodialysis patients treated in Dalian Municipal Central Hospital were enrolled in this study.Patients were categorized by ultrasound measurement of the vein diameter as stenosis group(diameter<2mm,n=75)or non-stenosis group(diameter≥2mm,n=109).Clinical data,Qa,RI,and Qx were recorded.Results The stenosis and non-stenosis groups were homogeneous in number,sex,BMI and smoking habit.Diabetes(t=0.059,P<0.001),Qa(c2=42.868,P<0.001),RI(c2=42.823,P<0.001)and Qx(c2=40.919,P<0.001)were different between stenosis group and non-stenosis group.Logistic regression showed that Qx was a valid index for evaluating AVF stenosis(OR=0.997,95%CI=0.995~0.998,P<0.001).ROC revealed that Qx was better than RI(AUC Qx-RI,P<0.001)but Qx and Qa had similar capability(AUC Qa-Qx,P=0.071)for the identification of AVF stenosis.Conclusions In hemodialysis patients,Qx was more reliable than RI but Qx and Qa had similar capability for the early identification of AVF stenosis.

关 键 词：彩色多普勒超声 血流量 阻力指数 动静脉内瘘狭窄 

分 类 号：R318.16[医药卫生—生物医学工程]