中国血液净化

›› 2007, Vol. 6 ›› Issue (7): 376-378.

• 论著 • 上一篇    下一篇

GPT法和超声稀释法在动静脉内瘘流量监测中的应用和比较

华 参 叶朝阳 李玲玲 梅长林   

  1. 200003 上海，第二军医大学附属长征医院肾内科全军肾脏病研究所
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-07-12 发布日期:2007-07-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2007-07-12 Published:2007-07-12

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摘要： 目的 观察和比较GPT法(glucose pump test)、超声稀释法在监测动静脉内瘘流量中的应用。方法 选择第二军医大学附属长征医院肾内科，全军肾脏病研究所透析中心长期维持性透析的39例患者，上机前用GPT法测定内瘘流量，正常上机后0.5h后用HD02型血液透析监测仪测定内瘘流量，对GPT法、超声稀释法测得流量＜500ml/min的患者2周内行内瘘彩超检查。结果 2例患者GPT法、超声稀释法均未能测出流量，4例患者GPT法前后血糖变化轻微无法计算流量。33例患者数据纳入分析，GPT法测定的内瘘流量均值高于超声稀释法，且具有统计学差异,两种方法测得内瘘流量存在直线相关。对GPT法、超声稀释法流量＜500ml6例患者行内瘘彩超检查，动静脉内瘘均有吻合口狭窄或近吻合口静脉段狭窄。结论 两种方法测定动静脉内瘘流量在临床均是可行的，能预先发现存在的血管通路狭窄。

关键词: 血管通路, 超声稀释法, GPT

Abstract: Objective To observe and compare glucose pump test (GPT) and ultrasound dilution (UD) for surveillance of blood flow rate in arteriovenous fistula (Qa). Methods Qa was determined using GPT and UD methods during hemodialysi in 39 patients with arteriovenous fistulas. For those whose Qa was <500ml from GPT and UD measurements, their fistulas were examined by color Doppler ultrasonography within 2 weeks. Results Qa was unable to be measured by GPT and UD in 2 cases, and could not be calculated form GPT method in 4 cases due to slight changes of blood glucose in the 2 blood samples. In the 33 patients their Qa could be measured by GPT and UD, the average QA from GPT was significantly higher than that from UD. Regression analysis showed a close correlation between the results from GPT and UD. In patients with Qa <500ml, their fistulas had stenosis in fistula stomas or venous stenosis near the stomas. Conclusion Both GPT and UD methods are clinically useful for surveillance of blood flow in arteriovenous fistulas and for prediction of stenosis in fistulas.

Key words: Ultrasound dilution technology, Glucose pump test

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