中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (08): 616-619.doi: 10.3969/j.issn.1671-4091.2024.08.010

• 血管通路 • 上一篇    下一篇

血压变异性对移植物动静脉内瘘功能的影响

陈双双     周建芳   胡 婷   尤金锭    黄加力   

  1. 310007 杭州，1杭州市中医院肾内科
  • 收稿日期:2024-03-14 修回日期:2024-04-23 出版日期:2024-08-12 发布日期:2024-08-12
  • 通讯作者: 周建芳 E-mail:ccychen97@163.com
  • 基金资助:
    浙江省医药卫生科技计划项目(2021KY)

Effect of blood pressure variability on graft arteriovenous fistula function

CHEN Shuang-shuang, ZHOU Jian-fang, HU Ting, YOU Jin-ding, HUANG Jia-li   

  1. Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, China
  • Received:2024-03-14 Revised:2024-04-23 Online:2024-08-12 Published:2024-08-12
  • Contact: 310007 杭州，1杭州市中医院肾内科 E-mail:ccychen97@163.com

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摘要： 目的 探讨血液透析患者血压变异性对移植物动静脉内瘘(arteriovenous graft，AVG)功能的影响。 方法 回顾性收集2020年12月用AVG为血管通路的患者作为研究对象，分析其连续4周血液透析时血压变异性，根据血压变异性中位数分为对照组(血压变异性＞17.3，n=40)和观察组(血压变异性≤17.3，n=40)，观察其血栓发生率及辅助初级通畅率，探讨其相关性。 结果 共纳入80例患者，观察1年内临床数据。对照组和观察组AVG血栓形成率分别为77.5%(31/40)和22.5%(9/40)，2组比较差异有统计学意义(χ2=24.200，P＜0.001)；对照组12个月辅助初级通畅率低于观察组(Log-rank χ2=63.870，P＜0.001)。 结论 血压变异性越高，血流动力学变化越大，移植物动静脉内瘘血栓形成的风险越高，建议临床上定期评估患者透析中血压变异性，并采取针对性的干预措施，降低血栓形成，提高辅助初级通畅率。

关键词: 血液透析, 移植物动静脉内瘘, 血压变异性, 血栓形成, 辅助初级通畅率

Abstract: Objective  To investigate the effect of blood pressure variability on the function of arteriovenous graft (AVG) in hemodialysis patients.  Methods A retrospective study was conducted to collect patients who used AVG as vascular access in December 2020. Blood pressure variability during hemodialysis for 4 consecutive weeks (12 times in total) was analyzed, and the patients were divided into control group (blood pressure variability >17.3, n=40) and observation group (blood pressure variability ≤17.3, n=40) according to the median blood pressure variability. The incidence of thrombosis and auxiliary primary patency rate were observed to explore their correlation.  Results  A total of 80 patients were included, and the clinical data within one year were observed. The AVG thrombosis rates in the control group and the observation group were 77.5% (31/40) and 22.5% (9/40), respectively, and the difference between the two groups was statistically significant (χ²=24.200, P<0.001). The 12-month auxiliary primary patency rate in the control group was lower than that in the observation group (Log-rank, χ²=63.870, P＜0.001).  Conclusion  The author believes that the higher the blood pressure variability, the greater the hemodynamic changes, and the higher the risk of thrombosis in AVG. It is recommended to evaluate blood pressure variability in dialysis regularly, and take targeted intervention measures to reduce thrombosis in AVG and improve the auxiliary primary patency rate.

Key words: Hemodialysis, Graft arteriovenous fistula, Blood pressure variability, Thrombosis, Auxiliary primary patency

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