摘要
目的探讨超声引导下的动静脉内瘘(AVF)穿刺对行血液透析患者血清胎球蛋白A(fetuin-A)、β_(2)微球蛋白(β_(2)-MG)、脂肪因子(Apelin)表达影响及临床安全性、有效性。方法回顾性分析2020年1月至2022年5月在我院血液透析中心进行治疗的148例血管条件欠佳的患者作为研究对象,按照治疗方式不同将该148例患者分为研究组(n=70)及对照组(n=78),研究组采用超声引导下AVF穿刺,对照组采用传统盲穿穿刺法,对比两组患者首穿成功率、血肿、血管并发症发生率;对比治疗前后血清fetuin-A、β_(2)-MG、Apelin表达;对比两组患者治疗总有效率,并按照疗效情况分为有效组(n=102)及无效组(n=46);对比有效组及无效组fetuin-A、β_(2)-MG、Apelin表达差异;绘制ROC曲线评估fetuin-A、β_(2)-MG、Apelin联合检测对穿刺疗效的预测效能。结果研究组的首穿成功率显著高于对照组,且血肿及血管病发生率显著低于对照组(P<0.05);相比于治疗前,两组患者治疗后的fetuin-A水平均显著上升,而β_(2)-MG、Apelin表达均显著降低(P<0.05),另外相比于对照组,研究组患者治疗后的fetuin-A水平显著更高,而β_(2)-MG、Apelin显著更低(P<0.05);治疗3个月后研究组的临床治疗有效率显著高于对照组(P<0.05);相比于无效组,有效组患者血清fetuin-A表达更高,而β_(2)-MG、Apelin表达显著降低(P<0.05);ROC验证显示fetuin-A、β_(2)-MG、Apelin联合检测对穿刺疗效的预测曲线下面积显著高于任意单一检测,灵敏度为91.18%,特异性为82.61%。结论超声引导下的AVF穿刺具有更高的临床疗效及临床安全性,能够有效改善患者血清fetuin-A、β_(2)-MG、Apelin表达。
Objective To investigate the clinical safety and efficacy of ultrasound-guided arteriovenous fistula(AVF)on the expression of fetuin-A,β_(2)microglobulin(β_(2)-MG)and adipokine(Apelin)in serum samples of hemodialysis patients.Methods 148 patients with poor vascular conditions who received treatment in hemodialysis center of our hospital from January,2020 to May,2022 were retrospectively analyzed as research objects.According to different treatment methods,148 patients were included in the study group(n=70)or the control group(n=78).The study group adopted ultrasound-guided AVF puncture.The traditional blind puncture method was used in the control group.The success rate of first puncture,hematoma and incidence of vascular complications were compared between the two groups.The expressions of fetuin-A,β_(2)-MG and Apelin in serum before and after treatment were compared.The total effective rate of the two groups was compared and divided into effective group(n=102)and ineffective group(n=46).The expressions of fetuin-A,β_(2)-MG and Apelin in effective and ineffective groups were compared.ROC curve was drawn to evaluate the predictive efficacy of fetuin-A,β_(2)-MG and Apelin combined tests for puncture efficacy.Results The success rate of the first penetration in the study group was significantly higher than that in the control group,and the incidence of hematoma and vascular disease was significantly lower than that in the control group(P<0.05).Compared with before treatment,fetuin-A levels in both groups were significantly increased after treatment,whileβ_(2)-MG and Apelin expressions were significantly decreased(P<0.05).In addition,fetuin-A levels in the study group were significantly higher than those in the control group after treatment.β_(2)-MG and Apelin were significantly lower(P<0.05);After 3 months of treatment,the clinical effective rate of the study group was significantly higher than that of the control group(P<0.05).Compared with ineffective group,fetuin-A expression was higher in the effective gr
作者
金丽珍
王姣姣
崔亚楠
谢志领
JIN Lizhen;WANG Jiaojiao;CUI Yanan;XIE Zhiling(Zhuozhou City Hospital,Baoding 072750,China)
出处
《标记免疫分析与临床》
CAS
2023年第2期279-283,351,共6页
Labeled Immunoassays and Clinical Medicine
基金
保定市科技计划项目(编号:2141ZF170)。
