目的 应用彩色多普勒超声评价自体动静脉内瘘吻合口处内膜增生程度,探讨其临床应用价值.方法 选取动静脉内瘘口狭窄患者18例(狭窄组)和自体动静脉内瘘正常的血液透析患者18例(对照组),超声测量两组患者动静脉内瘘口处内径和内膜厚度、动静脉内瘘血流量及瘘口处与流入道动脉峰值血流速度比值.结果 狭窄组动静脉内瘘口处内径和动静脉内瘘血流量均明显低于对照组[(0.11±0.03)cm vs.(0.23±0.04)cm,(375.78±124.56)ml vs.(1053.34±275.71)ml],差异均有统计学意义(均P<0.05),而动静脉内瘘口处内膜厚度及瘘口处与流入道动脉峰值血流速度比值均明显高于对照组[(0.09±0.03)cm vs.(0.05±0.02)cm,2.73±0.35 vs.1.85±0.21],差异均有统计学意义(均P<0.05).结论 动静脉内瘘口狭窄患者局部内膜明显增厚,彩色多普勒超声可直观、准确地评价动静脉内瘘吻合口处管腔变窄及局部内膜增生程度,具有重要临床应用价值.%Objective To evaluate the intimal hyperplasia at the location of arteriovenous fistula stenosis by color Doppler ultrasound,and to investigate the clinical application value.Methods The arteriovenous fistula stenosis group included 18 hemodialysis patients with arteriovenous fistula stenosis , while the control group included 18 hemodialysis patients with no complications of arteriovenous fistula.The diameter,the intima thickness and the blood flow parameters at the arteriovenous fistula were measured.The peak systolic velocity of fistula and upstream artery was recorded,the velocity ratio was calculated. Results The fistula diameter and the blood flow in the arteriovenous fistula stenosis group were obviously lower than those in the control group[(0.11±0.03)cm vs.(0.23±0.04)cm,(375.78±124.56)ml vs.(1053.34±275.71)ml],there were significant difference (all P<0.05),while the intima thickness and the velocity ratio in the arteriovenous fistula stenosis group were significantly higher than those in the control group[(0.09±0.03)cm vs.(0.05±0.02)cm,2.73±0.35 vs. 1.85±0.21],there were significant difference(all P<0.05).Conclusion The intima thickness in the fistula is thickened obviously in patients with arteriovenous fistula stenosis. Color Doppler ultrasound can accurately evaluate the degree of narrowing and intimal hyperplasia of the arteriovenous internal fistula.
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