钙磷乘积对血液透析患者动静脉内瘘球囊扩张术后内瘘失功的预测价值

Predictive value of calcium and phosphorus product for internal fistula failure after balloon dilation of arteriovenous fistula in hemodialysis patients

目的探讨钙磷乘积对血液透析患者动静脉内瘘球囊扩张术后内瘘失功的预测价值。方法选择2018年4月至2020年6月新疆医科大学第一附属医院收治的179例拟进行动静脉内瘘球囊扩张术的血液透析患者为研究对象,根据术后3个月患者是否并发内瘘失功分为内瘘失功组(86例)与非内瘘失功组(93例)。比较分析两组患者的临床资料。分析血液透析患者动静脉内瘘球囊扩张术后内瘘失功的影响因素以及钙磷乘积对内瘘失功的预测价值。结果内瘘失功组患者的吸烟比例、糖化血红蛋白、纤维蛋白原、钙磷乘积均显著高于非内瘘失功组(P<0.05)。多因素logistic回归分析结果显示,吸烟、糖化血红蛋白、纤维蛋白原和钙磷乘积是血液透析患者动静脉内瘘球囊扩张术后内瘘失功的独立影响因素(P<0.05)。受试者工作特征曲线分析显示,钙磷乘积预测血液透析患者动静脉内瘘球囊扩张术后内瘘失功的曲线下面积为0.785,敏感度和特异度分别为77.91%和77.42%。结论钙磷乘积在预测血液透析患者动静脉内瘘球囊扩张术后内瘘失功的发生中具有一定价值。

Objective To explore the predictive value of the product of calcium and phosphorus on the failure of internal fistula after balloon dilation of arteriovenous fistula in hemodialysis patients.Method 179 hemodialysis patients treated with balloon dilatation of active venous fistulas who were admitted to the First Affiliated Hospital of Xinjiang Medical University from April 2018 to June 2020 were selected as the research subjects.According to whether internal fistula failure occurred 3 months after operation,they were divided into internal fistula failure group(86 cases)and non-internal fistula failure group(93 cases).The clinical data of the two groups were compared and analyzed.To analyze the influencing factors of internal fistula failure after balloon dilation of arteriovenous fistula in hemodialysis patients and the predictive value of calcium and phosphorus product.Result The proportion of smoking,glycosylated hemoglobin,fibrinogen,calcium and phosphorus product in the internal fistula failure group were higher than those in the non-internal fistula failure group(P<0.05).Smoking,glycosylated hemoglobin,fibrinogen,calcium and phosphorus product were influencing factors for internal fistula failure after balloon dilation of arteriovenous fistula in hemodialysis patients(P<0.05).The area under the curve for predicting the fistula failure was 0.785,and the sensitivity and specificity were 77.91% and 77.42%.Conclusion The calcium-phosphorus product has certain value in predicting internal fistula failure after balloon dilation of arteriovenous fistula in hemodialysis patients.