自体动静脉内瘘成形术对维持性血液透析患者心脏结构及功能的影响

Effect of Autologous Arteriovenous Fistula Angioplasty on Cardiac Structure and Function in Maintenance Hemodialysis Patients

目的:探讨自体动静脉内瘘成形术对维持性血液透析患者心脏结构及功能的影响。方法:选取2018年6月—2020年6月于广州市第一人民医院行维持性血液透析的32例患者作为研究对象,均行自体动静脉内瘘成形术。比较患者术前及术后6个月心脏结构指标[左心室内径(LVD)、收缩末期内径(LVS)]、心脏功能指标[短轴缩短率(FS)、射血分数(EF)]、血流情况(主动脉瓣反流、二尖瓣反流和三尖瓣反流)、血流动力学指标[心脏指数(CI)和心排血量(CO)]。结果:术后6个月,患者LVD和LVS与术前比较,差异无统计学意义(P>0.05)。术后6个月,患者FS和EF与术前比较,差异无统计学意义(P>0.05)。术后6个月,患者主动脉瓣反流、二尖瓣反流和三尖瓣反流血流情况与术前比较,差异无统计学意义(P>0.05)。术后6个月,患者CI和CO与术前比较,差异无统计学意义(P>0.05)。结论:自体动静脉内瘘成形术未导致维持性血液透析患者心脏结构及功能发生显著变化,未出现明显的血流动力学改变,是理想的血管通路。

Objective:To investigate the effect of autologous arteriovenous fistula angioplasty on the cardiac structure and function in maintenance hemodialysis patients.Methods:A total of 32 maintenance hemodialysis patients in Guangzhou First People's Hospital from June 2018 to June 2020 were selected as the study subjects.All patients underwent autologous arteriovenous fistula angioplasty.Cardiac structure indexes [left ventricular diameter(LVD) and end systolic diameter(LVS)],heart function indexes[fractional shortening(FS) and ejection fraction(EF)],blood flow(including aortic regurgitation,mitral regurgitation and tricuspid regurgitation),and hemodynamic indexes [cardiac index(CI) and cardiac output(CO)] were compared before surgery and 6 months after surgery.Results:At 6 months after surgery,there was no significant difference in LVD and LVS compared with those before surgery(P>0.05).At 6 months after surgery,there was no significant difference in FS and EF compared with those before surgery(P>0.05).At 6 months after surgery,there was no significant difference in the blood flow of aortic regurgitation,mitral regurgitation and tricuspid regurgitation compared with those before surgery(P>0.05).At 6 months after surgery,there was no significant difference in CI and CO compared with those before surgery(P>0.05).Conclusion:Autologous arteriovenous fistula angioplasty does not cause any significant change on the cardiac structure and function in maintenance hemodialysis patients,has no obvious hemodynamic change,and it is an ideal vascular access.