维持性血液透析患者上肢动脉血管钙化的临床特点初探  

To explore the clinical characteristics of upper extremity arterial calcification in maintenance hemodialysis patients

作　　者：王尘 徐元恺[2] 杨艳丽 李文 阮琳 张丽红[1] WANG Chen;XU Yuan-kai;YANG Yan-li;LI Wen;RUAN Lin;ZHANG Li-hong(Department of Nephrology,The First Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Nephrology,Zhejiang Hospital,Hangzhou 310030,China)

机构地区：[1]河北医科大学第一医院肾内科,石家庄050000 [2]浙江医院肾内科,杭州310030

出　　处：《中国血液净化》2024年第9期659-662,共4页Chinese Journal of Blood Purification

基　　金：河北省重点科技研究计划(20221382)。

摘　　要：目的探讨维持性血液透析患者前臂动脉钙化病变分布特点及与血管通路的相关性。方法选取2021年2月─2021年6月在河北医科大学第一医院血液净化中心接受规律血液透析治疗的患者,收集临床资料,使用多普勒超声行双上肢桡动脉、尺动脉检查,记录钙化评分。结果共纳入118例患者,桡动脉、尺动脉整体钙化患病率情况:非内瘘侧尺动脉钙化患病率较桡动脉钙化患病率高(P=0.029),桡动脉在内瘘侧钙化患病率高于非内瘘侧患病率(P=0.015),内瘘侧尺动脉钙化患病率与桡动脉钙化患病率差异无统计学意义(P=0.557);尺动脉在内瘘侧与非内瘘侧患病率差异无统计学意义(P=0.405)。桡动脉、尺动脉不同节段钙化患病率情况:无论是内瘘侧还是非内瘘侧,桡动脉、尺动脉远心段钙化患病率均高于近心段(P=0.001、<0.001、<0.001、<0.001)。血管钙化严重程度比较:内瘘侧尺动脉钙化程度较桡动脉严重(χ^(2)=14.524,P=0.024);非内瘘侧尺动脉钙化程度较桡动脉严重(χ^(2)=17.522,P=0.004),差异有统计学意义;内瘘侧桡动脉钙化程度较非内瘘侧桡动脉严重(χ^(2)=12.943,P=0.044);内瘘侧尺动脉钙化严重程度与非内瘘侧尺动脉差异无统计学意义(χ^(2)=6.733,P=0.346)。结论维持性血液透析患者上肢动脉血管钙化患病率及严重程度远段均高于近段,尺动脉可能更易发生钙化。Objective To investigate the distribution characteristics of forearm artery calcification in maintenance hemodialysis patients and its correlation with vascular access.Methods Patients who received regular hemodialysis treatment in the Blood Purification Center of the First Hospital of Hebei Medical University from January 2023 to July 2023 were selected.Clinical data were collected.Doppler ultrasound was used to examine the radial artery and ulnar artery of both upper limbs,and the calcification score was recorded.Results A total of 118 patients were included.The overall prevalence of radial artery and ulnar artery calcification:the prevalence of ulnar artery calcification on the non-fistula side was higher than that of radial artery calcification(P=0.029),with a statistical difference.There were no significant difference of the prevalence of calcification between the ulnar artery and radial artery(P=0.557).In addition,the prevalence of calcification on the internal fistula side of the radial artery was significantly higher than that on the non-internal fistula side(P=0.015).The prevalence of calcification was no significant difference between ulnar artery fistula side and non-fistula side(P=0.405).The prevalence of calcification in different segments of the radial artery and ulnar artery:the prevalence of calcification in the distal segment of the radial artery and ulnar artery was higher than that in the proximal segment,regardless of the internal fistula side or the non-internal fistula side(P=0.001;P<0.001;P<0.001;P<0.001).Comparison of the severity of vascular calcification:the degree of calcification in the ulnar artery was more severe than that in the radial artery(χ^(2)=14.524,P=0.024),the difference was statistically significant.The calcification degree of the ulnar artery on the non-fistula side was more severe than that of the radial artery(χ^(2)=17.522,P=0.004),and the difference was statistically significant.The degree of calcification of the radial artery in the fistula side was more severe than

关 键 词：血管钙化 血液透析 多普勒超声 动脉 

分 类 号：R459.5[医药卫生—治疗学]