术前超声参数及血清白蛋白与动静脉内瘘成熟的相关性研究  

Study on correlation between preoperative ultrasound parameters and serum albumin levels,and maturation of arteriovenous fistula

作　　者：张宁 谢瑜娟[1] 陈胜江[1] Zhang Ning;Xie Yujuan;Chen Shengjiang(Department of Ultrasound,The First Affiliated Hospital of Henan University of Science&Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院超声科,洛阳471000

出　　处：《中国医学装备》2025年第1期58-62,67,共6页China Medical Equipment

基　　金：河南省医学科技公关计划(LHGJ20220689)。

摘　　要：目的:探讨术前超声参数及血清白蛋白(ALB)、低密度脂蛋白(LDL)水平与终末期肾病(ESRD)患者桡动脉-头静脉内瘘(RCF)成熟的相关性。方法:选择2022年1月至2023年9月期间在河南科技大学第一附属医院就诊并初次建立RCF通路的130例ESRD患者,所有患者造瘘术前均进行上肢血管及心脏超声检查,并检测血清ALB、LDL水平;根据术后内瘘成熟情况分为RCF成熟组(102例)和RCF成熟不良组(28例),对比分析两组患者术前超声参数及血清ALB、LDL水平与内瘘成熟的相关性。结果:RCF成熟组的头静脉扩张度、桡动脉直径、血清ALB水平均高于成熟不良组,血清LDL水平低于成熟不良组(t=3.810、3.401、3.405、-2.846,P<0.05)。实验室双指标(LDL+ALB)预测RCF成熟的受试者工作特征曲线下面积(AUC)为0.745(95%CI:0.647~0.842),灵敏度为77.50%,特异度为67.90%;超声双参数(头静脉扩张度+桡动脉直径)预测RCF成熟的AUC为0.809(95%CI:0.728~0.891),灵敏度为68.60%,特异度为82.10%;超声双参数联合实验室双指标预测RCF成熟的AUC为0.905(95%CI:0.847~0.962),灵敏度为76.50%,特异度为92.90%。Delong检验显示超声双参数联合实验室双指标预测RCF成熟的AUC值优于超声双参数和实验室双指标单独预测的AUC值,差异有统计学意义(Z=-2.899、-3.609,P<0.05)。结论:头静脉扩张度、桡动脉直径联合血清ALB、LDL对终末期肾病患者的内瘘成熟具有较高的预测价值。Objective:To investigate the correlation between preoperative ultrasound parameters,serum albumin(ALB),lowdensity lipoprotein(LDL)levels and the maturation of radial-cephalic fistula(RCF)in patients with end-stage renal disease(ESRD).Methods:A total of 130 ESRD patients who admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2022 to September 2023 and established RCF access for the first time were selected as the study subjects.All patients underwent ultrasound examinations on upper limb blood vessels and heart before fistula surgery,and serum ALB and LDL levels of them also were measured.According to the postoperative fistula maturation,the patients were divided into the fistula maturation group(102 cases)and the poor fistula maturation group(28 cases).And then,the correlations between the preoperative ultrasound parameters,serum ALB level,serum LDL level,and the fistula maturation in the two groups were compared and analyzed.Results:The cephalic vein dilation,radial artery diameter and serum ALB levels in the RCF maturation group were higher than those in the poor fistula maturation group,and the serum LDL level was lower than that in the poor fistula maturation group(t=3.810,3.401,3.405,-2.846,P<0.05),respectively.The area under curve(AUC)value of receiver operating characteristic(ROC)curve of laboratory dual indicators(LDL+ALB)was 0.745(95%CI:0.647-0.842)in predicting RCF maturation,and the sensitivity and specificity of that were respectively 77.50%and 67.90%.The AUC value of ultrasound dual parameters(cephalic vein dilation+radial artery diameter)was 0.809(95%CI:0.728~0.891)in predicting RCF maturation,and the sensitivity and specificity of that were respectively 68.60%and 82.10%.The AUC value of ultrasound dual parameters combined with laboratory dual indicators was 0.905(95%CI:0.847~0.962)in predicting RCF maturation,and the sensitivity and specificity of that were respectively 76.50%and 92.90%.The Delong test showed that the AUC value of ultrasound dual pa

关 键 词：术前超声 血清白蛋白(ALB) 动静脉内瘘成熟 终末期肾病(ESRD) 

分 类 号：R445.1[医药卫生—影像医学与核医学]