| 宋丽莎,杨伟兵,薛姗姗,周 敏,李 毅.彩色多普勒超声联合血清β2-微球蛋白评估血管通路动静脉内瘘的临床价值分析[J].,2023,(6):1141-1144 |
| 彩色多普勒超声联合血清β2-微球蛋白评估血管通路动静脉内瘘的临床价值分析 |
| Clinical Value of Color Doppler Ultrasonography Combined with Serum β2-microglobulin in Evaluating Vascular Access Arteriovenous Fistula |
| 投稿时间：2022-08-10 修订日期：2022-08-31 |
| DOI：10.13241/j.cnki.pmb.2023.06.028 |
| 中文关键词: 彩色多普勒超声 血管通路 动静脉内瘘 β2-微球蛋白 |
| 英文关键词: Color Doppler ultrasound Vascular access Arteriovenous fistula β2-microglobulin |
| 基金项目:陕西省卫生健康委科研基金项目（2022D068） |
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| 中文摘要: |
| 摘要 目的：探讨与分析彩色多普勒超声联合血清β2-微球蛋白评估血管通路动静脉内瘘的临床价值。方法：选择2019年1月-2022年6月在本院进行建立动静脉内瘘的血液透析患者210例作为研究对象，所有患者都在造瘘术前1d、术后3个月进行彩色多普勒超声检查与血清β2-MG检测，判断血管通路状况并进行相关性分析。结果：210例患者术后3个月的头静脉、桡动脉、内瘘口的内径、血流速度、血流量都明显高于术前1 d（P<0.05）。210例患者术后3个月的血清β2-微球蛋白含量明显低于术前1 d（P<0.05）。210例患者经过手术判定为动静脉内瘘异常22例，占比10.5 %，其中吻合口狭窄10例、内瘘头静脉端闭塞6例、静脉段血栓2例、吻合口血栓2例、静脉段狭窄2例。Spearsman分析显示动静脉内瘘异常与内瘘口血流速度、头静脉血流量、桡动脉内径、血清β2-微球蛋白含量存在相关性（P<0.05）。多因素logistic回归分析显示内瘘口血流速度、头静脉血流量、桡动脉内径、血清β2-微球蛋白含量为导致动静脉内瘘异常的重要因素（P<0.05）。结论：彩色多普勒超声可明确内瘘血流动力学和血管形态的变化，联合血清β2-微球蛋白检测可有效评估动静脉内瘘血管通路状况，监测内瘘使用功能与状态，为改善患者预后提供参考依据。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate and analysis the clinical values of color Doppler ultrasonography combined with serum β2-microglobulin in evaluating vascular access arteriovenous fistula. Methods: From January 2019 to June 2022, A total of 210 cases of hemodialysis patients who underwent arteriovenous fistula establishment in our hospital were selected as the research subjects. Ultrasonography and serum β2-MG detection were used to determine the vascular access status and conduct correlation analysis. Results: The inner diameter, blood flow velocity and blood flow of the cephalic vein, radial artery and internal fistula in 210 patients at 3 month after operation were higher than those at 1 day before operation (P<0.05). The serum β2-microglobulin content of 210 patients at 3 month after operation was lower than that at 1 day before operation (P<0.05). There were 22 cases were determined to be abnormal arteriovenous fistulas after surgery, accounted for 10.5 %, included 10 cases of anastomotic stenosis, 6 cases of occlusion of the venous end of the fistula, 2 cases of venous segment thrombosis, 2 cases of anastomotic thrombus, and venous segment thrombus. Stenosis in 2 cases in the 210 cases. Spearsman analysis showed that the abnormality of arteriovenous fistula was correlated with the blood flow velocity, cephalic vein blood flow, radial artery diameter and serum β2-microglobulin content (P<0.05). Multivariate logistic regression analysis showed that the blood flow velocity of the internal fistula, the blood flow of the cephalic vein, the diameter of the radial artery, and the content of serum β2-microglobulin were the important factors leaded to the abnormality of the arteriovenous fistula (P<0.05). Conclusion: Color Doppler ultrasonography can identify the changes of hemodynamics and vascular morphology of internal fistulas, combined with serum β2-microglobulin detection can effectively evaluate the vascular access status of arteriovenous fistulas, monitor the function of internal fistulas, and improve the prognosis of patients for reference. |
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