中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (01): 68-72.doi: 10.3969/j.issn.1671-4091.2026.01.016

• 血管通路 • 上一篇    下一篇

腹主动脉及桡动脉钙化与自体动静脉内瘘成熟的相关性研究

何聪爽   杨  涛   穆广琴   郜同心   葛桂珍   吕爱清   

  1. 100190 北京，北京市中关村医院1肾内科 3放射科
    102399 北京，2北京京煤集团总医院肾内科
  • 收稿日期:2025-06-03 修回日期:2025-08-17 出版日期:2026-01-12 发布日期:2025-12-31
  • 通讯作者: 杨涛 E-mail:yangtaodoctor@163.com

Clinical study on the correlation between calcification in abdominal aorta and radial artery and autogenous arteriovenous fistula maturation#br#

HE Cong-shuang, YANG Tao, MU Guang-qin, GAO Tong-xin, GE Gui-zhen, LYU Ai-qing   

  1. Department of Nephrology and 3Department of Radiology, Beijing Zhongguancun Hospital, Beijing 100190, China; 2Department of Nephrology, Beijing Jingmei Group General Hospital, Beijing 102399, China
  • Received:2025-06-03 Revised:2025-08-17 Online:2026-01-12 Published:2025-12-31
  • Contact: 100190 北京，北京市中关村医院1肾内科 E-mail:yangtaodoctor@163.com

摘要： 目的 探讨终末期肾病(end stage renal disease，ESRD)患者腹主动脉钙化(abdominal aortic calcification，AAC)、桡动脉钙化(radial artery calcification，RAC)与自体动静脉内瘘(arteriovenous fistula，AVF)成熟的关系及影响因素。 方法 纳入2023年4月—2024年12月在北京市中关村医院及北京京煤集团总医院接受AVF手术的ESRD患者，手术前采用X线评估AAC与RAC程度，行桡动脉-头静脉端侧吻合术，手术中记录桡动脉手术部位钙化情况。根据AAC程度将患者分为对照组与钙化组，手术后3个月，每月评估内瘘成熟情况，并记录成熟时间。 结果 共纳入75例患者，其中钙化组31例，对照组44例。对照组AVF成熟率高于钙化组(84.1%比58.1%，χ²=6.300，P=0.012)，钙化组成熟时间较对照组延长[(69.33±26.50)d比(46.54±17.92)d，t=-3.300，P=0.003]。单因素分析显示女性(OR=13.180，95% CI：0.038～0.376，P＜0.001)、年龄(OR=2.961，95% CI：0.995～1.086，P=0.085)、头静脉扩张度(OR=4.766，95% CI：0.053～0.854，P=0.029)、手术部位桡动脉钙化(OR=5.669，95% CI：1.258～10.629，P=0.017)、AAC(OR=3.817，95% CI：1.229～11.216，P=0.015)是内瘘成熟不良的影响因素。多因素分析显示女性(OR=11.477，95% CI：0.024～0.370，P=0.001)、头静脉扩张度(OR=4.664，95% CI：0.032～0.847，P=0.031)、手术部位桡动脉钙化(OR=5.788，95% CI：1.362～20.618，P=0.016)、AAC(OR=0.149，95% CI：0.028～0.786，P=0.025)为内瘘成熟不良的独立危险因素。 结论 AAC、手术部位桡动脉钙化、头静脉扩张度低、女性是自体动静脉内瘘成熟不良风险的独立危险因素。

关键词: 腹主动脉钙化, 桡动脉钙化, 自体动静脉内瘘, 内瘘成熟

Abstract: Objective  To investigate the relationship and influencing factors between abdominal aortic calcification (AAC), radial artery calcification (RAC), and arteriovenous fistula (AVF) maturation in patients with end-stage renal disease (ESRD).  Methods  A total of 75 ESRD patients undergoing AVF surgery were enrolled in this study. Preoperative X-ray was used to assess the degree of AAC and RAC, and end-to-side anastomosis of radial artery to cephalic vein was performed for AVF construction, with intraoperative recording of arterial calcification. Based on the degree of AAC, patients were divided into a control group (n=44) and a calcification group (n=31). After the surgery, AVF maturation was evaluated and maturation time was recorded every month for 3 months.  Results  The AVF maturation rate was significantly higher in the control group than in the calcification group (84.1% vs. 58.1%, χ²=6.300, P=0.012), and the maturation time was significantly longer in the calcification group (69.33±26.502 days vs. 46.54±17.925 days, t=-3.300, P=0.003) than in the control group. Univariate analysis showed that gender (OR=13.180, 95% CI: 0.038～0.376, P＜0.001), age (OR=2.961, 95% CI: 0.995～1.086, P=0.085), cephalic vein dilatation (OR=4.766, 95% CI: 0.053～0.854, P=0.029), intraoperative RAC (OR=5.669, 95% CI: 1.258～10.629, P=0.017), and AAC (OR=3.817, 95% CI: 1.229～11.216, P=0.015) were the risk factors for delayed AVF maturation. Multivariate analysis revealed that female gender (OR=11.477, 95% CI: 0.024～0.370, P=0.001), cephalic vein dilatation (OR=4.664, 95% CI: 0.032～0.847, P=0.031), intraoperative RAC (OR=5.788, 95% CI: 1.362～20.618, P=0.016), and AAC (OR=0.149, 95% CI: 0.028～0.786, P=0.025) were the independent risk factors for delayed AVF maturation.  Conclusion  AAC, intraoperative RAC, poor cephalic vein dilatation and female are the independent risk factors for delayed AVF maturation.

Key words: Abdominal aortic calcification, Radial artery calcification, Arteriovenous fistula, Fistula maturation

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