不同因素对尿毒症患者前臂自体动静脉内瘘初次失功的影响

The Effect of Different Factorson the Initial Dysfunction of Forearm Arteriovenous Fistula in Uremia Patients

目的:探讨不同因素对尿毒症患者前臂自体动静脉内瘘(AVF)初次失功的影响。方法:回顾性分析从本院选取336名行前臂AVF (手术方式桡动脉与头静脉端侧吻合,动静脉直径均】2 mm)的成年尿毒症患者的一般临床资料、用药情况等,采用Kaplan-Meier生存曲线分析不同药物治疗组AVF的生存差异,Cox多因素回归模型分析AVF失功的危险因素。结果:在纳入研究的患者中,有72例(21.4%)患者发生了AVF的失功,12个月及24个月时AVF的通畅率分别为78.0%和66.0%。AVF失功组与通畅组相比,两组之间在年龄、性别、用药情况等指标上均无统计学差异,但是AVF失功组血磷水平明显高于通畅组[2.03 (1.68~2.29) vs. 1.69 (1.38~2.12) mmol/L, P = 0.01]。结论:血磷升高为AVF失功的独立危险因素。

Objective: To explore the effect of different factors on the initial dysfunction of forearm arteriovenous fistula in uremia patients. Methods: The general clinical data and medications of 336 adult uremic patients with forearm AVF (The radial artery and cephalic vein were anastomosed end to side, and the diameter of the artery and vein was more than 2 mm) from our hospital were studied by retrospective analysis. The survival times of overall and different groups were evaluated by the Life table and Kaplan-Meier curves. Multivariable Cox regression analysis was used to study the factors associated with the dysfunction of AVF. Results: Among the patients included in the study, 72 (21.4%) had AVF dysfunction, and the patency rate of AVF was 78.0% and 66.0% at 12 and 24 months, respectively. There was no significant difference in age, gender and drug use be-tween the two groups, but the level of the serum phosphorus in AVF group was significantly higher than that in normal group [2.03 (1.68 - 2.29) vs. 1.69 (1.38 - 2.12) mmol/L, P = 0.01]. Conclusions: The increase of the serum phosphorus was an independent risk factor for AVF failure.