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血透患者动静脉内瘘直径对心脏功能影响的相关性研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第6期
页码:
699-701
栏目:
临床研究
出版日期:
2006-12-25

文章信息/Info

Title:
Correlativity between diameter of arteriovenous fistula and cardiac function in hemodialysis patients
作者:
马中1; 陈威2; 韩增辉3; 刘洪宝2; 孙世仁2; 王汉民2
第四军医大学西京医院： 1.血管外科, 2.肾脏内科, 3.超声诊断科, 陕西 西安 710032
Author(s):
MA Zhong1;  CHEN Wei2;  HAN Zeng-hui3;  LIU Hong-bao2;  SUN Shi-ren2;  WANG Han-min2
1.Department of Vascular Surgery, 2.Department of Nephrology, 3.Department of ultrasonic, Xijing Hospital, Fourth Military Medical University, Xi′an,Shaanxi 710032, China
关键词:
血液透析; 动静脉内瘘; 瘘口直径; 心功能
Keywords:
hemodialysis; arteriovenous fistula; diameter; cardiac function
分类号:
R331.31;R543
DOI:
-
文献标识码:
A
摘要:
目的 探讨血液透析患者自体动静脉内瘘(AVF)瘘口直径对心脏功能的影响及相关关系。方法 以54例接受AVF制作的血液透析患者为研究对象，根据术后彩色多普勒超声所测得的瘘口直径(AVFD)，将患者分为A组11例(直径2.0～2.9 mm)；B组27例(直径3.0～3.9 mm)；C组16例(直径4.0～4.9 mm)。每组患者手术前、术后行心脏彩色多普勒超声检查，观察并严格记录心排出量(CO)、心脏指数(CI)、射血分数(EF)、动静脉内瘘血流量(AVFB)，分析3组不同AVFD对血液透析患者心脏功能的影响及相关性。结果 3组患者AVF术后CO、CI值比术前显著增高(P<0.01)，而EF值术前、术后变化不明显。3组患者的AVFB、AVFD与CO差值(△CO)、CI差值(△CI)呈直线正相关 (r=0.518, P<0.05)。A、B、C 3组AVFB、△CO、△CI随AVFD增大而递增，且相互间存在显著差异 (P<0.05)。结论 血透患者AVF瘘口直径大小与心脏功能的变化密切相关，适当的瘘口直径对于减小AVF对心功能的影响，以保持AVF血流长期通畅至关重要。
Abstract:
AIM To determine the relationship between the diameter of arteriovenous fistula (AVF) and the cardiac function in hemodialysis (HD) patients. METHODS Fiftyfour HD patients who received surgeries of forearm arteriovenous fistula were divided into three groups according to the diameter of arteriovenous fistula (AVFD) detected by Doppler ultrasound: 11 cases in group A (AVFD 2.0~2.9 mm), 27 cases in group B (AVFD 3.0~3.9 mm), and 16 cases in group C (AVFD 4.0~4.9 mm). The CO, CI, EF as well as AVFB detected by Doppler ultrasound before and after the operation of AVF were recorded, respectively. The influence of different diameters of AVFD on the cardiac function as well as the relationship between them was analyzed. RESULTS CO and CI were apparently increased after the operation of AVF (P<0.01), but EF had few changes in the three groups. AVFB and AVFD were linearly correlated to △CO and △CI (r=0.518, P<0.05) in the three groups. AVFB, △CO and △CI in group A, B, and C were significantly increased with the diameters of AVF and there was a remarkable difference among the three groups (P<0.05). CONCLUSION The diameter of AVF of HD patients is closely correlated to the cardiac function. The suitable diameter of AVF is significant in minimizing the influence of the cardiac function and keeping a long time patency of fistula itself.

参考文献/References

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［4］ Engdberts L, Tordoir JH, Boon ES, et al. Hightoutput failure due excessive shunting in a hemodialysis access fistula: an easily over looked diagnosis［J］. Am J Nephrol, 1995,15(4):323-326.

［5］ 高国静,邢秀荣,贾强. 血透对慢性肾功能衰竭患者心脏结构和功能的影响［J］. 中国医学影像技术, 2000, 16(5):381-383.

备注/Memo

备注/Memo:
收稿日期：2006-04-28.作者简介：马中，主治医师，博士 Tel：(029)84775271 Email：mazhong@fmmu.edu.cn
更新日期/Last Update: