自体动静脉内瘘侧肢体肱动脉血流量的影响因素分析  

Analysis of factors affecting brachial artery flow of lateral limb of autologous arteriovenous fistula

作　　者：王小琴[1] 周祥 张庆庆[1] 杜爽[1] Wang Xiao-qin;Zhou Xiang;Zhang Qing-qing;Du Shuang(Department of Nephrology,Xinjiang Clinical Research Center for Kidney Disease,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 832001,China)

机构地区：[1]新疆肾脏病临床医学研究中心(新疆维吾尔自治区人民医院)肾病科,新疆维吾尔自治区832001

出　　处：《临床肾脏病杂志》2025年第2期115-120,共6页Journal Of Clinical Nephrology

基　　金：新疆护理学会科研项目(2023XH034);新疆维吾尔自治区自然科学基金项目(2021D01C143)。

摘　　要：目的分析影响透析患者自体动静脉内瘘(autogenous arteriovenous fistula,AVF)侧肢体肱动脉流量的主要因素。方法选取2021年7月至10月新疆维吾尔自治区人民医院血净中心的血液透析(hemodialysis,HD)患者为研究对象,选择AVF侧肢体肱动脉流量<600 mL/min的31例患者为观察组,选择肱动脉流量≥600 mL/min的116例患者为对照组,收集并分析AVF患者相关临床资料。结果单因素分析结果显示,患者的年龄显著高于对照组(P<0.001),舒张压低于对照组(P=0.006),观察组中吻合口近端动脉流入道收缩期峰值速度(peak systolic velocity,PSV)、近端动脉流入道内径(P=0.006)、吻合口内径(P=0.020)、吻合口近端静脉流出道PSV(P=0.029)、透析前血尿素氮(P=0.002)、血清钙(P=0.024)和肌酐(P=0.019)均低于对照组;进行Logistic回归分析,结果显示,近端动脉流入道PSV(OR=0.982,95%CI:0.968~0.995,P=0.008)、透析前血尿素氮(OR=0.820,95%CI:0.709~0.948,P=0.007)可能是AVF侧肢体肱动脉流量的主要影响因素。结论近端动脉流入道PSV、透析前血尿素氮可能是影响肱动脉流量是主要因素,分析影响AVF侧肢体肱动脉血流量的因素,有助于指导医务人员预防和治疗AVF功能不良。Objective To analyze the main factors affecting the brachial artery flow of lateral limb in dialysis patients underwent autologous arteriovenous fistula(AVF).Methods Hemodialysis(HD)patients in the Blood Net Center of People’s Hospital of Xinjiang Uygur Autonomous Region from July 2021 to October 2021 were selected as the study objects.Thirty-one patients with brachial artery flow of lateral limb<600 mL/min were selected as the observation group,and 116 patients with brachial artery flow of lateral limb≥600 mL/min were selected as the control group.Relevant clinical data of patients underwent AVF were collected and analyzed.Results Univariate analysis showed a significantly older age(P<0.001),and lower diastolic blood pressure(P=0.006)in the observation group than the control group.In the observation group,the peak systolic velocity(PSV)of the proximal anastomosis artery,the inflow diameter of the proximal artery(P=0.006),the inner diameter of the anastomosis(P=0.020),PSV of the proximal anastomosis artery(P=0.029),pre-permeable blood urea nitrogen(P=0.002),serum calcium(P=0.024)and creatinine(P=0.019)were significantly lower than those of the control group.Logistic regression analysis showed that PSV of proximal arterial inflow(OR=0.982,95%CI:0.968-0.995,P=0.008),and pretreatment blood urea nitrogen(OR=0.820,95%CI:0.709-0.948,P=0.007)were the main factor affecting brachial artery flow of lateral limb in AVF.Conclusions PSV in the proximal arterial inflow tract,pre-transfusion blood urea nitrogen are the main factors affecting brachial artery flow of lateral limb,and analyzing the factors affecting brachial artery flow of lateral side in AVF can help to guide the medical staff in preventing and treating AVF malfunction.

关 键 词：肾透析 动静脉内瘘 肱动脉流量 

分 类 号：R54[医药卫生—心血管疾病]