彩色多普勒超声联合血清β2-微球蛋白评估血管通路动静脉内瘘的临床价值分析  

Clinical Value of Color Doppler Ultrasonography Combined with Serum β2-microglobulin in Evaluating Vascular Access Arteriovenous Fistula

作　　者：宋丽莎[1] 杨伟兵 薛姗姗 周敏 李毅[4] SONG Li-sha;YANG Wei-bing;XUE Shan-shan;ZHOU Min;LI Yi(Department of ultrasonography lab,3201th Affiliated Hospital,School of Medicine,Xi'an Jiaotong University,Hanzhong,Shaanxi,723000,China;Department of Ultrasound Medicine,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi,710089,China;Department of ultrasonography lab,The First Affiliated Hospital of Air Force Military Medical University,Xi'an,Shaanxi,710032,China;Department of Nephrology,3201th Affiliated Hospital,School of Medicine,Xi'an Jiaotong University,Hanzhong,Shaanxi,723000,China)

机构地区：[1]西安交通大学医学院附属三二〇一医院超声科,陕西汉中723000 [2]西安交通大学第一附属医院超声医学科,陕西西安710089 [3]空军军医大学第一附属医院超声科,陕西西安710032 [4]西安交通大学医学院附属三二〇一医院肾病内科,陕西汉中723000

出　　处：《现代生物医学进展》2023年第6期1141-1144,1150,共5页Progress in Modern Biomedicine

基　　金：陕西省卫生健康委科研基金项目(2022D068)。

摘　　要：目的:探讨与分析彩色多普勒超声联合血清β2-微球蛋白评估血管通路动静脉内瘘的临床价值。方法:选择2019年1月-2022年6月在本院进行建立动静脉内瘘的血液透析患者210例作为研究对象,所有患者都在造瘘术前1d、术后3个月进行彩色多普勒超声检查与血清β2-MG检测,判断血管通路状况并进行相关性分析。结果:210例患者术后3个月的头静脉、桡动脉、内瘘口的内径、血流速度、血流量都明显高于术前1 d(P<0.05)。210例患者术后3个月的血清β2-微球蛋白含量明显低于术前1 d(P<0.05)。210例患者经过手术判定为动静脉内瘘异常22例,占比10.5%,其中吻合口狭窄10例、内瘘头静脉端闭塞6例、静脉段血栓2例、吻合口血栓2例、静脉段狭窄2例。Spearsman分析显示动静脉内瘘异常与内瘘口血流速度、头静脉血流量、桡动脉内径、血清β2-微球蛋白含量存在相关性(P<0.05)。多因素logistic回归分析显示内瘘口血流速度、头静脉血流量、桡动脉内径、血清β2-微球蛋白含量为导致动静脉内瘘异常的重要因素(P<0.05)。结论:彩色多普勒超声可明确内瘘血流动力学和血管形态的变化,联合血清β2-微球蛋白检测可有效评估动静脉内瘘血管通路状况,监测内瘘使用功能与状态,为改善患者预后提供参考依据。Objective:To investigate and analysis the clinical values of color Doppler ultrasonography combined with serumβ2-microglobulin in evaluating vascular access arteriovenous fistula.Methods:From January 2019 to June 2022,A total of 210 cases of hemodialysis patients who underwent arteriovenous fistula establishment in our hospital were selected as the research subjects.Ultrasonography and serumβ2-MG detection were used to determine the vascular access status and conduct correlation analysis.Results:The inner diameter,blood flow velocity and blood flow of the cephalic vein,radial artery and internal fistula in 210 patients at 3 month after operation were higher than those at 1 day before operation(P<0.05).The serumβ2-microglobulin content of 210 patients at 3 month after operation was lower than that at 1 day before operation(P<0.05).There were 22 cases were determined to be abnormal arteriovenous fistulas after surgery,accounted for 10.5%,included 10 cases of anastomotic stenosis,6 cases of occlusion of the venous end of the fistula,2 cases of venous segment thrombosis,2 cases of anastomotic thrombus,and venous segment thrombus.Stenosis in 2 cases in the 210 cases.Spearsman analysis showed that the abnormality of arteriovenous fistula was correlated with the blood flow velocity,cephalic vein blood flow,radial artery diameter and serumβ2-microglobulin content(P<0.05).Multivariate logistic regression analysis showed that the blood flow velocity of the internal fistula,the blood flow of the cephalic vein,the diameter of the radial artery,and the content of serumβ2-microglobulin were the important factors leaded to the abnormality of the arteriovenous fistula(P<0.05).Conclusion:Color Doppler ultrasonography can identify the changes of hemodynamics and vascular morphology of internal fistulas,combined with serumβ2-microglobulin detection can effectively evaluate the vascular access status of arteriovenous fistulas,monitor the function of internal fistulas,and improve the prognosis of patients for reference.

关 键 词：彩色多普勒超声 血管通路 动静脉内瘘 Β2-微球蛋白 

分 类 号：R459.5[医药卫生—治疗学] R445.1[医药卫生—临床医学]