[1]谢嘉平,徐维茜,杨洁珂,等.血液透析糖尿病患者自体动静脉内瘘失功影响因素及预测模型临床研究[J].陕西医学杂志,2024,(5):641-645.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.014]
　XIE Jiaping,XU Weixi,YANG Jieke,et al.Influencing factors and predictive model of loss of autologous arteriovenous fistula in diabetic patients on hemodialysis[J].,2024,(5):641-645.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.014]
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血液透析糖尿病患者自体动静脉内瘘失功影响因素及预测模型临床研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年5期
页码:
641-645
栏目:
临床研究
出版日期:
2024-05-05

文章信息/Info

Title:
Influencing factors and predictive model of loss of autologous arteriovenous fistula in diabetic patients on hemodialysis
作者:
谢嘉平; 徐维茜; 杨洁珂; 卿山林
(成都医学院第二附属医院·核工业四一六医院肾内科,四川 成都 610051)
Author(s):
XIE Jiaping; XU Weixi; YANG Jieke; QING Shanlin
(Department of Nephrology,the 2nd Affiliated Hospital of Chengdu Medical College-Nuclear Industry 416 Hospital,Chengdu 610051,China)
关键词:
糖尿病;  血液透析;  自体动静脉内瘘;  影响因素;  预测模型
Keywords:
Diabetes mellitus;  Hemodialysis;  Autogenous arteriovenous fistula;  Influencing factors;  Predictive model
分类号:
R 587.1
DOI:
DOI:10.3969/j.issn.1000-7377.2024.05.014
文献标志码:
A
摘要:
目的:探讨血液透析糖尿病患者自体动静脉内瘘(AVF)失功的影响因素,建立预测模型并进行验证。方法:选取接受血液透析的糖尿病患者105例,根据血液在透析过程中的流动情况分为AVF失功组(58例)和AVF通畅组(47例)。采用倾向性评分匹配调整均衡性,调整后两组均38例。采用多因素Logistic回归分析血液透析糖尿病患者AVF失功的影响因素。采用R软件构建列线图并进行验证。结果:与AVF通畅组比较,AVF失功组患者有低血压史、营养不良、血肿、前臂动静脉内径<4 mm以及HbA1c≥7%的比例较高,且PTH、CRP、血清铁、血小板、血钾升高,透析血流量降低(均P<0.05)。有低血压史、营养不良、血肿、前臂动静脉内径<4 mm、HbA1c≥7%、血清铁>90 μg/dl是血液透析糖尿病患者AVF失功的独立危险因素(均P<0.05)。构建列线图模型后,验证结果显示模型在预测血液透析糖尿病患者AVF失功方面具有良好的区分度与拟合度,准确度较高。结论:有低血压史、营养不良、血肿、前臂动静脉内径<4 mm、HbA1c≥7%、血清铁>90 μg/dl是血液透析糖尿病患者AVF失功的独立危险因素。所构建的列线图模型准确度较高。
Abstract:
Objective:To investigate the influencing factors of loss of autologous arteriovenous fistula(AVF)in diabetic patients on hemodialysis,establish a predictive model and verify it.Methods: A total of 105 diabetic patients receiving hemodialysis were selected and divided into AVF loss group(58 cases)and AVF patency group(47 cases)according to the blood flow during hemodialysis.Propensity score matching was used to adjust the balance,with 38 cases in both groups after adjustment.Multivariate Logistic regression was used to analyze the influencing factors of loss of AVF in diabetic patients on hemodialysis.R software was used to build the nomogram and verify it.Results: Compared with the AVF patency group,the AVF loss group had a higher proportion of hypotension history,malnutrition,hematoma,forearm arteriovenous diameter<4 mm and HbA1c≥7%,and the parathyroid hormone(PTH),C-reactive protein(CRP),serum iron,platelet and potassium were increased,and dialysis blood flow was decreased(all P<0.05).History of hypotension,malnutrition,hematoma,forearm arteriovenous diameter<4 mm,HbA1c≥7%,serum iron>90 μg/dl were independent risk factors for AVF loss in hemodialysis diabetic patients(all P<0.05).After constructing the nomogram model,the verification results showed that the model had good differentiation and fitting degree and high accuracy in predicting AVF loss in hemodialysis diabetic patients.Conclusion:History of hypotension,malnutrition,hematoma,forearm arteriovenous diameter<4 mm,HbA1c≥7%,serum iron>90 μg/dl are independent risk factors for AVF loss in hemodialysis diabetic patients.The accuracy of the nomogram model is high.

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备注/Memo

备注/Memo:
基金项目:四川省科技计划项目(2020JDJQ0048)
更新日期/Last Update: 2024-05-06