| 陈颖慧,陈鸿雁,张秉宜,熊狄,万珍,何晏霖.超声引导下经皮腔内血管成形术治疗自体动静脉瘘血栓闭塞的危险因素[J].中国介入影像与治疗学,2025,22(6):380-384 |
| 超声引导下经皮腔内血管成形术治疗自体动静脉瘘血栓闭塞的危险因素 |
| Risk factors of ultrasound-guided percutaneous transluminal angioplasty for treating thrombotic occlusion of autogenous arteriovenous fistula |
| 投稿时间：2025-03-13 修订日期：2025-05-04 |
| DOI：10.13929/j.issn.1672-8475.2025.06.003 |
| 中文关键词: 肾透析 动静脉瘘 血管成形术 超声检查，介入性 列线图 |
| 英文关键词:renal dialysis arteriovenous fistula angioplasty ultrasonography, interventional nomograms |
| 基金项目:江西省卫生健康委科技计划（SKJP220218611）。 |
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| 中文摘要: |
| 目的 分析超声引导下皮腔内血管成形术（PTA）治疗自体动静脉瘘（AVF）血栓闭塞的危险因素。方法 回顾性纳入144例接受超声引导下PTA的自体AVF血栓闭塞患者，根据治疗成功与否将其分为成功组（n=114）与失败组（n=30）；比较2组临床资料及AVF超声参数，构建多因素logistic回归模型，分析PTA治疗自体AVF血栓闭塞的危险因素并以列线图可视化；绘制受试者工作特征曲线，计算曲线下面积（AUC），评估模型预测效能。结果 失败组年龄、AVF使用年限、血管钙化程度、血栓杨氏模量平均值（Emean）、最大值（Emax）及最小值（Emin）均高于，而AVF静脉流出道数量低于成功组（P均＜0.05）。血管中-重度钙化、血栓高Emean、AVF静脉流出道数量为1均为超声引导下PTA治疗自体AVF血栓闭塞的独立危险因素（P均＜0.05），所获模型预测治疗失败的AUC为0.969。结论 血管中-重度钙化、高血栓Emean、AVF静脉流出道数量为1均为超声引导下PTA治疗自体AVF血栓闭塞的独立危险因素。 |
| 英文摘要: |
| Objective To analyze the risk factors of ultrasound-guided percutaneous transluminal angioplasty （PTA） for treating thrombotic occlusion of autogenous arteriovenous fistula （AVF）. Methods A total of 144 patients with thrombotic occlusion of autologous AVF were retrospectively enrolled and divided into success group （n=114） and failure group （n=30） according to the success of treatment or not. Clinical data and ultrasonic parameters of AVF were compared between groups. A multivariate logistic regression model was constructed to analyze the risk factors of PTA for treating thrombotic occlusion of autologous AVF， and the results were visualized by nomogram. Then receiver operating characteristic curve was drawn， and the area under the curve （AUC） was calculated to evaluate the predictive efficacy of this model. Results Patients’ age， use years of AVF， degree of vascular calcification， the mean Young modulus （Emean）， the maximum Young modulus （Emax） and the minimum Young modulus （Emin） were all higher， while the number of venous outflow tracts of AVF was less in failure group than those in success group （all P＜0.05）. Moderate to severe calcification of vascular， high Emean of thrombus and 1 venous outflow tract of in AVF were all independent risk factors of ultrasound-guided PTA for treating thrombotic occlusion of autologous AVF （all P＜0.05）， and AUC of the obtained model for predicting failure of treatment was 0.969. Conclusion Moderate to severe calcification of vascular， high Emean of thrombus and 1 venous outflow tract of AVF were all independent risk factors of ultrasound-guided PTA for treating thrombotic occlusion of autologous AVF. |
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