摘要
目的 探讨动静脉内瘘狭窄PTA术后通畅率影响因素。方法 本次研究共计选择62例患者作为研究对象，样本在本医院进行检查的时间为2023年1月-2024年12月，均为动静脉内瘘狭窄PTA术患者。按照检查结果将其分为未发生组（复查时内瘘属于通畅）和已发生组（复查时内瘘属于不畅），以此比较影响通畅率的因素。结果 未发生组的高血压患者数量显著高于发生组，表示高血压病史与PTA术后通畅率存在一定关联（P＜0.05）；甲状旁腺功能亢进会增加患者术后的再狭窄风险（P＜0.05）；炎症反应是能够影响术后通畅率的因素（P＜0.05）；血糖能够影响术后通畅率（P＜0.05）；营养状态较好的患者术后的再狭窄风险更低（P＜0.05）；总胆固醇会影响到术后再狭窄（P＜0.05）；血脂紊乱可能与术后再狭窄有关联（P＜0.05）。结论 本次研究发现，有6项指标为动静脉内瘘狭窄PTA术后通畅率影响因素，分别为高血压、甲状旁腺激素、炎症反应、血糖、白蛋白、甘油三酯，需要着重控制这几项指标，有助于患者后续恢复。
关键词： 动静脉内瘘狭窄PTA术；术后通畅率；影响因素；对照研究；关键变量
Abstract
Objective To investigate the factors influencing the patency rate after PTA for arteriovenous fistula stenosis. Methods A total of 62 patients were selected as study subjects, with examinations conducted at our hospital from January 2023 to December 2024. All patients underwent PTA for arteriovenous fistula stenosis. Based on examination results, they were divided into the unoccurred group (with patent fistula at re-examination) and occurred group (with non-patent fistula at re-examination) to compare factors affecting patency rate. Results The number of hypertensive patients in the non-stenosis group was significantly higher than in the stenosis group, indicating a certain association between hypertension history and post-PTA patency rate (P<0.05). Hyperparathyroidism increased the risk of postoperative restenosis (P<0.05). Inflammatory response was a factor influencing postoperative patency rate (P<0.05). Blood glucose levels affected postoperative patency rate (P<0.05). Patients with better nutritional status had a lower risk of postoperative restenosis (P<0.05). Total cholesterol influenced postoperative restenosis (P<0.05). Dyslipidemia may be associated with postoperative restenosis (P<0.05). Conclusion This study identified six factors affecting post-PTA patency rate for arteriovenous fistula stenosis: hypertension, parathyroid hormone, inflammatory response, blood glucose, albumin, and triglycerides. These factors require focused control to facilitate subsequent recovery.
Key words： Arteriovenous fistula stenosis PTA procedure; Postoperative patency rate; Influencing factors; Controlled study; Key variables
参考文献 References
[1] 邵丹妮,甘文渊,曾星若,黄小妹,刘昌璇,陈文莉.首次动静脉内瘘狭窄患者经皮腔内血管成形术后通畅率影响因素分析[J].临床肾脏病杂志,2025,25(5):355-361.
[2] 刘旭廷,鞠少荣,陈泳金,张真.超声引导下球囊扩张成形术治疗自体动静脉内瘘狭窄的效果及通畅率影响因素分析[J].医学理论与实践,2025,38(5):793-796.
[3] 刘坤,胡旭琦,郭兴友,范卫东,张拓,李明,徐峰.动静脉内瘘失功术后血液透析通路通畅情况的影响因素分析[J].血管与腔内血管外科杂志,2025,11(9):1205-1210.
[4] 李国才.影响超声引导下动静脉内瘘扩张术后通畅率的因素分析[J].世界复合医学(中英文),2025,11(2):6-9.
[5] 陈芽,魏嵬,李冰城,万茂林,张波,李春林,刘四斌,竺瑾怡,苏子良,吴文泽.动静脉内瘘重建术和经皮球囊扩张术治疗自体动静脉内瘘狭窄效果及术后内瘘低血流量影响因素分析[J].临床误诊误治,2025,38(7):50-54
[6] 苏宝庭.动静脉内瘘狭窄经皮球囊血管成形术治疗效果的影响因素分析及干预对策[J].中外医药研究,2025, 4(12):34-36.
[7] 钟小亮,陈芸,宋嫣,张芳,陈颖慧.自体动静脉内瘘狭窄患者PTA手术治疗效果及影响因素[J].中国医学创新, 2023,20(8):151-155.
[8] 田关源,郑玲,钟晓泽,吴义强,吴武忠.血液透析患者动静脉内瘘早期失功的影响因素及血压节律、血压变异性变化[J].现代医学与健康研究电子杂志,2022,6(8):36-40.