目的 回顾性分析血液透析患者腹主动脉钙化与经皮血管成形术(percutaneous transluminal angioplasty,PTA)后动静脉内瘘(arteriovenous fistula，AVF)通畅时间的关系。 方法 选取2018年6月—2021年11月在沧州市人民医院首次行经皮血管成形术的患者120例，记录其行PTA手术时的腹主动脉钙化评分(abdominal aortic calcification score,AACs)，根据AACs结果将患者分成高钙化组和低钙化组，观察3年内2组患者PTA手术后的AVF一期通畅率，并对影响PTA手术后AVF一期通畅率的因素进行相关性分析。 结果 高钙化组患者的一期通畅时间明显短于低钙化组患者(t =2.358， P=0.020)。6、12、24、36个月时，低钙化组的一期通畅率为93.9%、84.7%、67.4%、53.6%，而高钙化组患者的内瘘一期通畅率为92.6%、79.4%、56.3%、39.6%，差异有统计学意义(χ2=4.827，P=0.028)。多因素回归分析提示AACs(HR=2.893,95% CI：1.160～7.212，P=0.023)、AVF使用龄(HR=0.545,95% CI：0.320～0.928，P=0.026)均与患者PTA手术后AVF失功相关。 结论 腹主动脉钙化、内瘘使用龄是PTA手术后动静脉内瘘再狭窄的重要预测因子。
Objective To retrospectively analyze the relationship between abdominal aortic calcification (AAC) and arteriovenous fistula patency period after percutaneous transluminal angioplasty (PTA). Methods A total of 120 patients treated with PTA for the first time in Cangzhou People's Hospital from June 2018 to November 2021 were enrolled in this study. Their AAC score at the time of PTA operation were recorded. According to the AAC score, the patients were divided into high AAC group and low AAC group. Their primary AVF patency rate after PTA was followed up for 3 years. The influencing factors for primary AVF patency period after PTA were analyzed. Results The primary patency period was significantly shorter in high AAC group than in low AAC group (t =2.358, P=0.020). After 6, 12, 24 and 36 months, the primary AVF patency rates were 93.9%, 84.7%, 67.4% and 53.6% in low AAC group, and were 92.6%, 79.4%, 56.3% and 39.6% in high AAC group (χ2=4.827, P=0.028). Multivariate adjusted COX regression found that AAC score (HR=2.893, 95% CI:1.160～7.212, P=0.023) and AVF age (HR=0.545, 95% CI:0.320～0.928, P=0.026) were significantly associated with AVF dysfunction after PTA. Conclusions AAC and AVF age are important predictors for AVF restenosis after PTA.
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