超声参数及ET-1对动静脉内瘘术患者内瘘成熟度的评估价值  

Value of Ultrasonic Parameters and ET-1 on Arteriovenous Fistula Maturity in Patients Post Arteriovenous Fistula Surgery

作　　者：王磊 边莉莉 WANG Lei;BIAN Lili(Color Ultrasonic Room,The Fifth Hospital of Yulin City,Yulin Shaanxi 719000)

机构地区：[1]榆林市第五医院彩超室,陕西榆林719000 [2]延安市第二人民医院超声科,陕西延安716000

出　　处：《医学临床研究》2023年第12期1839-1841,1845,共4页Journal of Clinical Research

摘　　要：【目的】探讨超声参数联合内皮素-1(ET-1)对动静脉内瘘术后内瘘成熟度的评估价值。【方法】回顾性分析2020年8月至2022年8月榆林市第五医院收治的82例行动静脉内瘘术患者的临床资料,根据患者内瘘成熟情况将其分为成熟组(71例)与未成熟组(11例)。比较两组术前及术后8周桡动脉血流动力学指标[收缩期峰值(PSV)、舒张期峰值流速(EDV)、阻力指数(RI)]、桡动脉血管直径(RAD)和血流速度(RVF)、头静脉血管直径(CVD)和血流速度(CVF)、ET-1水平;采用受试者工作特征(ROC)曲线分析RAD、RVF、PSV、EDV、RI、ET-1及各项联合对动静脉内瘘术后内瘘成熟度的预测价值。【结果】术前及术后8周,成熟组RAD、RVF、PSV、EDV及ET-1水平显著高于未成熟组(P<0.05),RI显著低于未成熟组(P<0.05)。ROC曲线分析证实:RAD、RVF、PSV、EDV、RI、ET-1能够用于内瘘成熟度的预测,曲线下面积分别为0.757、0.814、0.841、0.762、0.789、0.855。各项联合预测的曲线下面积为0.918,敏感度为0.986,特异度为0.909,各项指标联合预测的效能高于单独检测。【结论】超声测量参数联合ET-1可用于评估动静脉内瘘术后内瘘成熟度,具有较高的临床应用价值。【Objective】To explore the evaluative value of ultrasonic parameters in conjunction with Endothelin-1(ET-1)on the maturity of arteriovenous fistulas in patients with post arteriovenous fistula surgery.【Methods】A retrospective analysis was conducted on the clinical data of 82 patients who underwent arteriovenous fistula surgery at The Fifth Hospital of Yulin City from August 2020 to August 2022.Patients were divided into the mature group(71 cases)and the immature group(11 cases)based on the maturity of the fistula.Preoperative and postoperative 8-week radial artery hemodynamic indicators[Peak Systolic Velocity(PSV),End-Diastolic Velocity(EDV),Resistive Index(RI)],radial artery diameter(RAD)and blood flow volume(RVF),cephalic vein diameter(CVD)and blood flow volume(CVF),and ET-1 levels were compared between the two groups.The predictive value of RAD,RVF,PSV,EDV,ET-1,and RI on the maturity of arteriovenous fistulas post-surgery was analyzed using the Receiver Operating Characteristic(ROC)curve.The predictive efficacy of the combination of RAD,RVF,PSV,EDV,RI,and ET-1 on arteriovenous fistula maturity was assessed using consistency analysis.【Results】Preoperatively and at 8 weeks postoperatively,the mature group had significantly higher levels of RAD,RVF,PSV,EDV,and ET-1(P<0.05),and a significantly lower RI(P<0.05)compared to the immature group.ROC curve analysis confirmed that RAD,RVF,PSV,EDV,RI、ET-1 could be used to predict the maturity of fistulas with areas under the curve of 0.757,0.814,0.841,0.762,0.789,0.855,respectively.Furthermore,the area under the curve,sensitivity and specificity of the combined prediction were 0.918,0.986 and 0.909,respectively.The efficiency of the all indexes combined prediction was higher than that of the single detection.【Conclusion】Ultrasonic measurement parameters combined with ET-1 can be used for the assessment of arteriovenous fistula maturity post-surgery and have clinical applicative value.

关 键 词：动静脉瘘/外科学 动静脉瘘/影像诊断 内皮缩血管肽1/血液 

分 类 号：R543[医药卫生—心血管疾病]