维持性血液透析病人发生动静脉内瘘栓塞的危险因素分析

摘要

目的:分析维持性血液透析病人发生动静脉内瘘栓塞的危险因素.方法:回顾性分析首次行动静脉内瘘形成术并进行维持性血液透析的137例病人资料,将其中发生动静脉内瘘栓塞的24例病人作为观察组,将未发生动静脉内瘘栓塞的113例病人作为对照组,分析比较2组病人各项临床资料及生活指标.结果:2组病人心脑血管疾病、糖尿病、透析次数、使用左卡尼汀、血小板、白蛋白、三酰甘油、低密度脂蛋白、C反应蛋白、甲状旁腺激素、血磷、钙磷乘积差异均有统计学差异(P<0.05～P<0.01);logistic回归分析结果显示,糖尿病、使用左卡尼汀、低密度脂蛋白、钙磷乘积、血磷5个因素进入logistic回归模型,均为影响动静脉内瘘栓塞发生的危险因素(P<0.05～P<0.01).结论:糖尿病、低密度脂蛋白升高、钙磷乘积过高以及血磷水平升高是影响维持性血液透析病人发生动静脉内瘘栓塞的独立危险因素,而使用左卡尼汀则是维持性血液透析病人发生动静脉内瘘栓塞的保护因素.%Objective:To investigate the risk factors of the occurrence of arteriovenous fistula embolization in maintenance hemodialysis patients. Methods:The clinical data of 137 patients treated with the first arteriovenous fistula forming operation combined with maintenance hemodialysis were retrospectively analyzed. Twenty-four cases with arteriovenous fistula embolization and 113 cases without arteriovenous fistula embolization were divided into the observation group and control group,respectively. The clinical data and life index between two groups were compared. Results:The differences of cardiovascular and cerebrovascular diseases, diabetes mellitus,frequency of dialysis, L-carnitine usage, platelet count, albumin, triglyceride, low density lipoprotein, C reactive protein, parathyroid hormone,serum phosphorus, and calcium-phosphorus product between two groups were statistically significantusage ( P <0. 05 to P<0. 01). The results of the logistic regression analysis showed that the diabetes mellitus,L-carnitine usage,low density lipoprotein,calcium-phosphorus product and serum phosphorus entered into the logistic regression model were the risk factors of affecting the occurrence of arteriovenous fistula embolization(P<0. 05 to P<0. 01). Conclusions:The diabetes mellitus,low density lipoprotein increasing, high calcium-phosphorus product and serum phosphorus increasing are the independent risk factors of the occurrence of arteriovenous fistula embolization in maintenance hemodialysis patients,and the use of L-carnitine is the protective factor of the occurrence of arteriovenous fistula embolization in maintenance hemodialysis patients.