【摘要】 目的研究血液透析患者血管钙化程度与其动静脉内瘘失功的临床关系。方法选取我院2014年1月～2018年1月接受血液透析干预的患者72例,根据其血管钙化程度分为重度组(n=26)、轻中度组(n=22)和无血管钙化组(n=24)。分析三组各临床指标变化,同时对血管钙化程度与动静脉内瘘失功关系进行研究。结果重度组血肌酐水平、透析时间要明显高于轻中度组、无血管钙化组各指标水平,组间数据比较差异有统计学意义(P<0.05);但重度组血磷水平、血红蛋白水平以及钙磷乘积与轻中度组、无血管钙化组比较,差异无统计学意义(P>0.05)。23例患者发生动静脉内瘘失功情况,发生率为31.94%(23/72),其中重度组发生13例(56.52%),轻中度组发生7例(30.43%),无血管钙化组发生3例(13.04%);49例患者未发生动静脉内瘘失功。动静脉内瘘失功患者的桡动脉钙化、血红蛋白以及血磷、透析时间、血肌酐、钙磷乘积与非动静脉内瘘失功患者各指标比较,差异有统计学意义(P<0.05)。经过Logistic回归分析,血红蛋白水平是血液透析患者行动静脉内瘘失功的危险因素(P<0.05)。结论血液透析患者血管钙化程度与动静脉内瘘失功发生有着十分密切的关系,接受血液透析时间越长,患者的血肌酐水平越高,引起患者发生血管钙化的风险也会明显增加,同时会进一步提升患者发生动静脉内瘘失功的机率。更多还原

【Abstract】 Objective To study the clinical relationship between the degree of vascular calcification and arteriovenous fistula in hemodialysis patients. Methods 72 patients who underwent hemodialysis intervention from January 2014 to January 2018 in our hospital were enrolled. According to their vascular calcification, they were divided into severe group(n=26), mild to moderate group(n=22) and avascular calcification group(n=24). The changes of clinical indexes in the three groups were analyzed, and the relationship between the degree of vascular calcification and arteriovenous fistula was studied. Results The levels of serum creatinine and dialysis in the severe group were significantly higher than those in the mild to moderate group and the avascular calcification group. There was a statistically significant difference between the groups(P<0.05). However, the serum phosphorus level, glycosylated hemoglobin level and calcium-phosphorus product between the severe group and the mild to moderate group, the avascular calcification group had no significant difference(P>0.05). 23 patients had arteriovenous dysfunction, and the incidence rate was 31.94%(23/72),including 13 cases(56.52%) in the severe group and 7 cases(30.43%) in the mild to moderate group, and 3 cases(13.04%)in the avascular calcification group. 49 patients did not have arteriovenous dysfunction. The radial artery calcification,hemoglobin, blood phosphorus, dialysis time, serum creatinine, calcium and phosphorus product in patients with arteriovenous dysfunction were significantly different from those in patients with arteriovenous fistula dysfunction( P<0.05).After Logistic regression analysis, hemoglobin level was a risk factor for arteriovenous fistula of hemodialysis patients(P <0.05). Conclusion The degree of vascular calcification in hemodialysis patients is closely related to the occurrence of arteriovenous fistula. The longer the hemodialysis time, the higher the serum creatinine level, and the risk of vascular calcification is also increased. At the same time, it will further increase the chance of patients with arteriovenous fistula.更多还原