自体动静脉内瘘成熟不良多因素回归研究  

Multivariate Regression Study on Immature Autologous Internal Arteriovenous Fistula

作　　者：王稻[1] 廖雯[1] 曹珊[1] 刘灏灏 孙纷纷 WANG Dao;LIAO Wen;CAO Shan;LIU Haohao;SUN Fenfen(Pingxiang People's Hospital,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院,江西萍乡337000

出　　处：《中国医学创新》2023年第17期166-171,共6页Medical Innovation of China

基　　金：萍乡市科技计划项目(2021PY033)。

摘　　要：目的:探讨自体动静脉内瘘成熟不良的影响因素并构建预测模型。方法:选取2016年6月-2021年6月萍乡市人民医院1001例建立自体动静脉内瘘的慢性肾脏病5期患者为研究对象。根据患者内瘘是否成熟分为内瘘成熟组(n=735)和内瘘成熟不良组(n=266)。收集患者临床资料,用多因素logistic回归分析内瘘成熟不良的影响因素,并构建预测模型,评价模型的预测价值。结果:肥胖(OR=2.542)、糖尿病(OR=4.923)、低蛋白血症(OR=3.408)、桡动脉内径(OR=0.416)、头静脉内径(OR=0.587)、C反应蛋白(OR=3.487)是自体动静脉内瘘成熟不良的影响因素(P<0.05)。构建预测模型:Y=1/(1+e-x),X=-2.958+0.933×肥胖+1.594×糖尿病+1.226×低蛋白血症-0.877×桡动脉内径-0.533×头静脉内径+1.249×C反应蛋白。ROC曲线下面积为0.820[95%CI(0.794,0.846),P<0.001],敏感度为81.55%,特异度为67.26%。结论:肥胖、糖尿病、低蛋白血症、桡动脉内径、头静脉内径、C反应蛋白与自体动静脉内瘘成熟不良密切相关,本研究构建的模型预测价值良好,可供临床借鉴。Objective:To investigate the influencing factors of immature autologous internal arteriovenous fistula and construct a prediction model.Method:A total of 1001 patients with stage 5 chronic kidney disease who had established autologous internal arteriovenous fistula in Pingxiang People's Hospital from June 2016 to June 2021 were selected as the research subjects.According to whether the patients'internal fistula had mature,they were divided into mature internal fistula group(n=735)and immature internal fistula group(n=266).The clinical data of patients were collected,and the influencing factors of immature autologous internal arteriovenous fistula were analyzed by multivariate logistic regression,and a prediction model was constructed,and its predictive value was evaluated.Result:Obesity(OR=2.542),diabetes(OR=4.923),hypoproteinemia(OR=3.408),diameter of radial artery(OR=0.416),diameter of cephalic vein(OR=0.587)and C reactive protein(OR=3.487)were influencing factors of immature autologous internal arteriovenous fistula(P<0.05).The prediction model was constructed:Y=1/(1+e-x),X=-2.958+0.933×obesity+1.594×diabetes+1.226×hypoalbuminemia-0.877×diameter of radial artery-0.533×diameter of cephalic vein+1.249×C reactive protein.The area under the ROC curve was 0.820[95%CI(0.794,0.846),P<0.001],the sensitivity was 81.55%,and the specificity was 67.26%.Conclusion:Obesity,diabetes,hypoproteinemia,diameter of radial artery,diameter of cephalic vein and C reactive protein are closely related to immature autologous internal arteriovenous fistula,the model constructed in this study has good prediction value and can be used for clinical reference.

关 键 词：自体动静脉内瘘 内瘘成熟 影响因素 预测模型 回归分析 

分 类 号：R692.5[医药卫生—泌尿科学]