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目的:分析维持性血液透析(MHD)患者动静脉内瘘(AVF)的超声参数特征及其与AVF功能不良之间的关系。方法:采集以AVF为透析通路的MHD患者临床信息,于非透析日行超声检查,监测血流动力学参数及评估AVF并发症情况。结果:将患者按内瘘功能分为功能良好组(115例)和功能不良组(29例),两组平均肱动脉流量分别为1 150.62±63.6 ml/min及803.84±108.91 ml/min(P<0.05),桡动脉流量分别为765.82±34.97ml/min及478.57±67.36 ml/min(P<0.01),肱动脉阻力指数(RI)分别为0.48±0.01及0.55±0.03(P<0.01),桡动脉RI分别为0.35±0.01及0.39±0.02(P<0.05),将肱动脉和桡动脉的RI、流量、瘘口直径分别按四分位法进行分组,统计各组内瘘功能不良发生率,发现当肱动脉流量<641.3 ml/min、桡动脉流量<428.3 ml/min、桡动脉RI>0.41、瘘口直径<0.39 cm时,AVF功能不良发生率显著升高。结论:本研究证实AVF超声参数与其功能之间具有良好的相关性,内瘘超声检查可为AVF功能不良早期实施干预措施提供依据和参考。
Objective: To analyze the characteristics of ultrasound parameters of arteriovenous fistula (AVF) in patients with maintenance hemodialysis (MHD) and its relationship with the dysfunction of AVF. Methods: The clinical data of MHD patients who took AVF as dialysis pathway were collected. Ultrasonography was performed on non-dialysis day to monitor the hemodynamic parameters and evaluate the complications of AVF. Results: According to the fistula function, the patients were divided into two groups: the well-functioned group (115 cases) and the dysfunctional group (29 cases). The average brachial flow rates were 1 150.62 ± 63.6 ml / min and 803.84 ± 108.91 ml / min <0.05). The radial artery flow rates were 765.82 ± 34.97 ml / min and 478.57 ± 67.36 ml / min, respectively. The brachial artery resistance index (RI) were 0.48 ± 0.01 and 0.55 ± 0.03 (P <0.01) RI of radial artery were 0.35 ± 0.01 and 0.39 ± 0.02 respectively (P <0.05). RI, flow rate and diameter of fistula of brachial artery and radial artery were grouped according to quartile method. The incidence of fistula dysfunction Found that the incidence of AVF dysfunction was significantly increased when the brachial artery flow rate was <641.3 ml / min, radial artery flow rate <428.3 ml / min, radial artery RI> 0.41, and fistula diameter <0.39 cm. CONCLUSIONS: This study confirms the good correlation between the parameters of AVF and its function. Ultrasound examination of fistula can provide the basis and references for the early intervention of AVF dysfunction.