转化医学杂志2025，Vol.14Issue(8)：20-24,5.DOI:10.3639/j.issn.2095-3097.2025.08.005
外周血NAR联合RAR在预测动静脉内瘘经皮腔内血管成形术后再狭窄中的临床价值
Clinical Value of Peripheral Blood NAR Combined with RAR in Predicting Restenosis after Percutaneous Transluminal Angioplasty of Arteriovenous Fistula
摘要
Abstract
Objective To explore the clinical value of the neutrophil-to-apolipoprotein A1 ratio(NAR)combined with the red blood cell distribution width-to-albumin ratio(RAR)in predicting restenosis after percutaneous transluminal angioplasty(PTA)of arteriovenous fistula.Methods A total of 182 patients with arteriovenous fistula dysfunction who underwent PTA at Affiliated Hospital of Hebei University of Engineering from April 2021 to May 2024 were enrolled.Patients were followed up for one year postoperatively and divided into a patency group(95 case)and a restenosis group(87 case)based on the occurrence of restenosis.Preoperative peripheral blood levels of neutrophils,apolipoprotein A1,red blood cell distribution width(RDW),and albumin were measured to calculate NAR and RAR.Predictive value was analyzed using ROC curves,and influencing factors were assessed by multivariate Logistic stepwise regression analysis.Results The restenosis rate was 47.80%among the 182 patients.Peripheral blood NAR and RAR were significantly higher in the restenosis group than in the patency group(P<0.05).ROC curve analysis showed AUC of 0.774 and 0.839 for NAR and RAR alone,respectively,in predicting restenosis.The combined prediction using NAR and RAR yielded an AUC of 0.906,which was significantly better than either alone(Z=12.905,10.029,P<0.001).Multivariate Logistic stepwise regression analysis identified comorbid diabetes,low lymphocyte,NAR≥3.15,and RAR≥0.43 as independent risk factors for restenosis(OR=2.195,95%CI:1.290-3.733,P=0.004;OR=2.519,95%CI:1.441-4.404,P=0.001;OR=2.861,95%CI:1.708-4.790,P<0.001;OR=3.133,95%CI:1.747-5.619,P<0.001).Conclusion Elevated peripheral blood NAR and RAR are independent risk factors for restenosis after PTA of arteriovenous fistula.The combination of NAR and RAR has high clinical value in predicting post-PTA restenosis.关键词
中性粒细胞/载脂蛋白A1比值/红细胞分布宽度/白蛋白比值/动静脉内瘘/经皮腔内血管成形术/再狭窄/预测价值Key words
neutrophil-to-apolipoprotein A1 ratio/red blood cell distribution width-to-albumin ratio/arteriovenous fistula/percutaneous transluminal angioplasty/restenosis/predictive value引用本文复制引用
陆云,程征涛,齐龙伟,李桂英,王晓英,王桃霞,李建炜..外周血NAR联合RAR在预测动静脉内瘘经皮腔内血管成形术后再狭窄中的临床价值[J].转化医学杂志,2025,14(8):20-24,5.基金项目
河北省医学科学研究项目(20190956) （20190956）
