超声监测肱动脉阻力指数评估自体动-静脉内瘘功能不全  

Evaluation of autogenous arteriovenous fistula insufficiency by ultrasound monitoring of brachial artery resistance index

作　　者：孙菲菲 陶杰 李向莲 陈重 冯谦 张小娟 Sun Feifei;Tao Jie;Li Xianglian;Chen Zhong;Feng Qian;Zhang Xiaojuan(Department of Ultrasound,the General Hospital of Western Theater Command,Chengdu 610083,China;Kidney Internal Medicine,the General Hospital of Western Theater Command,Chengdu 610083,China)

机构地区：[1]西部战区总医院超声诊断科,成都610083 [2]西部战区总医院肾脏内科,成都610083

出　　处：《中华超声影像学杂志》2023年第4期318-323,共6页Chinese Journal of Ultrasonography

摘　　要：目的探讨超声监测肱动脉阻力指数(RI)对自体动-静脉内瘘(AVF)功能不全的评估价值。方法回顾性分析2019年1月至2021年6月在西部战区总医院行彩色多普勒超声检测的828例AVF术后患者的肱动脉血流RI及血流量(FV)数据。以临床透析是否充分为标准进行分组,其中AVF功能正常组668例,功能不全组160例,比较两组间一般资料和超声测量参数的差异。分析肱动脉FV与RI的相关性。运用ROC曲线分析肱动脉血流RI对AVF功能不全的评估效能。结果两组间肱动脉RI及FV差异有统计学意义(均P<0.001)。Pearson相关性分析显示,肱动脉FV与RI呈负相关(r=-0.657,P<0.001)。采用肱动脉血流RI评估AVF功能的ROC曲线下面积为0.970,95%CI=0.955~0.986,最佳截断值为0.665,敏感性与特异性分别为0.888、0.955。结论AVF功能不全患者的肱动脉RI明显高于AVF功能正常的患者,肱动脉RI的最佳截断值可作为快速筛查AVF功能的重要评估参数。Objective To evaluate the autogenous arteriovenous fistula(AVF)insufficiency by ultrasound monitoring of brachial artery resistance index(RI).Methods The brachial artery RI and blood flow volume(FV)data of 828 patients who underwent color-Doppler ultrasound detection after AVF in the General Hospital of Western Theater Command from January 2019 to June 2021 were retrospectively analyzed.The patients were grouped according to the adequacy of clinical dialysis,including 668 patients in the group with normal AVF function and 160 patients in the group with insufficient AVF function.The general information and ultrasonic measurement parameters were compared between the two groups.The correlation between brachial artery FV and RI was analyzed.The evaluation of brachial artery flow RI for AVF insufficiency was analyzed by ROC curve.Results There were statistically significant differences between the two groups in brachial artery RI and FV(both P<0.001).The results of Pearson correlation analysis showed that brachial artery FV was negatively correlated to RI(r=-0.657,P<0.001).The area under ROC curve for assessing AVF function by brachial artery RI was 0.970,with 95%CI was 0.955-0.986,the optimal cut-off value was 0.665,and the sensitivity and specificity were 0.888 and 0.955,respectively.Conclusions Brachial artery RI in patients with AVF insufficiency is significantly higher than that in patients with normal AVF function.The optimal cutoff value of brachial artery RI can be used as an evaluation parameter for rapid screening of AVF function.

关 键 词：超声检查 多普勒 彩色 血液透析 动-静脉内瘘 肱动脉 血流量 阻力指数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543[医药卫生—诊断学]