陕西医学杂志2024，Vol.53Issue(5)：641-645,5.DOI:10.3969/j.issn.1000-7377.2024.05.014
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
Influencing factors and predictive model of loss of autologous arteriovenous fistula in diabetic patients on hemodialysis
摘要
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,malnu-trition,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 pg/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 differentia-tion 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 pg/dl are independent risk factors for AVF loss in hemodialysis diabetic patients.The accuracy of the nomogram model is high.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Key words
Diabetes mellitus/Hemodialysis/Autogenous arteriovenous fistula/Influencing factors/Predictive model分类
医药卫生引用本文复制引用
谢嘉平,徐维茜,杨洁珂,卿山林..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,2024,53(5):641-645,5.基金项目
四川省科技计划项目(2020JDJQ0048) （2020JDJQ0048）
