[1]熊礼佳,吴潮清,王浩宇,等.上肢袢形人工血管动静脉瘘通畅率的影响因素分析[J].大众科技,2019,21(11):63-65.
　Clinical Applications of Upper Limb Arteriovenous Loop Graft and Risk Factors of Patency Loss[J].Popular Science & Technology,2019,21(11):63-65.
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上肢袢形人工血管动静脉瘘通畅率的影响因素分析()
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《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
21
期数:
2019年11
页码:
63-65
栏目:
医药与卫生
出版日期:
2019-11-20

文章信息/Info

Title:
Clinical Applications of Upper Limb Arteriovenous Loop Graft and Risk Factors of Patency Loss
作者:
熊礼佳;  吴潮清;  王浩宇;  张燕飞;  唐业莹;  覃宗蕙
（广西壮族自治区人民医院，广西 南宁 530021）
关键词:
人工血管动静脉瘘; 通畅率; 高危因素
Keywords:
arteriovenous graft;  patency rates;  risk factors
文献标志码:
A
摘要:
目的：分析上肢袢形人工血管动静脉瘘（arteriovenous graft，AVG）通畅率的影响因素。方法：回顾性分析 2016年 1 月至 2017 年 12 月广西壮族自治区人民医院肾内科实施 19 例 AVG 手术的终末期肾病（end stage of renal disease, ESRD）患 者临床资料，应用 t 检验和 Fisher 确切概率法比较闭塞组与通畅组临床指标差异，探讨影响 AVG 通畅率的因素。结果：上肢 AVG 的 6 个月和 1 年初级通畅率均为 84.2%，次级通畅率分别为 57.8%、63.1%。通畅组和闭塞组组间比较发现年龄、性别、透 析龄、多次通路失功史、收缩压（systolic BP,SBP）、舒张压（diastolic BP,DBP）、血白蛋白（serum Albumin, Alb）、血钙（serum calcium, Ca）、血磷（serum phosphorus, P）、血甲状旁腺素（intact parathyroid hormone, iPTH）差异无统计学意义（P>0.05），吸 烟史、CRP、P 差异有统计学意义（P＜0.05）。结论：有吸烟史、高 CRP、高 P 血症是影响 AVG 通畅率的高危因素。
Abstract:
Objective: This study aimed to assess primary patency rates of arteriovenous graft and the risk factors of patency loss. Methods: A total of 19 patients who needed AVG for hemodialysis in our department from January 2016 to December 2017 were retrospectively reviewed. Clinical data and patency rates were obtained in a retrospective manner. Statistical analysis was performed with the T test and Fisher’s exact test. Results: The primary patency rates were 84.2% both at 6 months and 1 year. The secondary patency rates were 57.8% at 6 months, but 63.1% at one-year. There was no significant difference in age, gender, duration of dialysis, SBP, DBP, serum albumin, calcium, intact parathyroid hormone between AVG with patency loss and AVG without patency loss (P>0.05). Meanwhile, smoking, multiple vascular access failure, CRP and serum phosphorus were significantly associated with primary patency rates. Conclusion: Various factors were associated with the development of patency loss of AVG, such as smoking, multiple vascular access failure, CRP and serum phosphorus.

参考文献/References:

[1] 中国医师协会肾脏病医师分会血液透析充分性协作组. 中国血液透析充分性临床实践指南[J].中华医学杂志, 2015,95(34): 2748-2753. [2] National Kidney Foundation. DOQI clinical practice guidelines and clinical practice recommendation updates: vascular access[J]. AJKD, 2006(48): s1- s322. [3] 金其庄,王玉柱,叶朝阳,等.中国血液透析用血管通路专家 共识（第 2 版）[J].中国血液净化,2019,18(6):365-381. [4] 成功,张宪生,尹杰,等.胸壁与上肢人工血管透析通路的 通畅率及影响因素比较[J].中国微创外科杂志,2016, 16(4):289-293. [5] 张丽红,王玉柱.北美血管通路协会血液透析血管通路标 准化定义解读[J].中国血液净化,2013,12(3):167-169. [6] Fabbri LM. Smoking, Not COPD, as the Disease[J]. New England Journal of Medicine, 2016, 374(19): 1885-1886. [7] Breitenstein A, Stampfli S F, Reiner M F, et al. The MAP kinase JNK2 mediates cigarette smoke-induced arterial thrombosis[J]. Thrombosis and Haemostasis, 2017, 117(01): 83-89. [8] Stirbu O, Gadalean F, Pitea I V, et al. C-reactive protein as a prognostic risk factor for loss of arteriovenous fistula patency in hemodialyzed patients[J]. Journal of Vascular Surgery, 2019, 70(1): 208-215. [9] Heine G H, Ortiz A, Massy Z A, et al. Monocyte subpopulations and cardiovascular risk in chronic kidney disease[J]. Nature Reviews Nephrology, 2012, 8(6): 362- 369. [10] Moon J Y, Lee M L, Lee S H, et al. Hyperphosphatemia is associated with patency loss of arteriovenous fistula after 1 year of hemodialysis[J]. Kidney Research and Clinical Practice, 2015, 34(1): 41-46. [11] Voelkl J, Lang F, Eckardt K U, et al. Signaling pathways involved in vascular smooth muscle cell calcification during hyperphosphatemia[J]. Cellular and Molecular Life Sciences, 2019, 76(11): 2077-2091.

备注/Memo

备注/Memo:
【收稿日期】2019-09-10 【基金项目】广西卫生和计划生育委员会自筹课题（Z2016598）。【作者简介】熊礼佳（1981－），女，广西壮族自治区人民医院肾内科副主任医师，硕士，研究方向为透析用血管通路。
更新日期/Last Update: 2020-02-15