Kim Young Ok, Choi Yeong Jin, Kim Ji Il, Kim Young Soo, Kim Byung Soo, Park Chul Whee, Song Ho Cheol, Yoon Sun Ae, Chang Yoon Sik, Bang Byung Kee
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2006 Apr;21(2):284-9. doi: 10.3346/jkms.2006.21.2.284.
This study was performed to investigate the impact of intima-media thickness (IMT) of radial artery on early failure of radiocephalic arteriovenous fistula (AVF) in hemodialysis (HD) patients. Ninety uremic patients undergoing radiocephalic AVF operation were included in this study. During the operation, 10-mm long partial arterial walls were removed with elliptical form for microscopic analysis. Specimens were stained with trichrome and examined by a pathologist blinded to the clinical data. And then AVF patency was followed up for 1 yr after the operation. Of the total 90 patients, 31 patients (34%) had AVF failure within 1 yr after the operation. Mean IMT was thicker in failed group (n=31) than in patent group (n=59) (486+/-130 micrometer vs. 398+/-130 micrometer, p=0.004). The AVF patency rate within 1 yr after the operation was lower in patients with IMT > or = 500 micrometer (n=26) than in patients with IMT <500 micrometer (n=64) (p=0.017). Age was an independent risk factor of IMT. Diabetes mellitus tended to be independent risk factor but not statistically significant. Our data suggest that increased radial artery IMT is closely associated with early failure of radiocephalic AVF in HD patients.
本研究旨在探讨桡动脉内膜中层厚度（IMT）对血液透析（HD）患者头静脉桡动脉动静脉内瘘（AVF）早期失功的影响。本研究纳入了90例行头静脉桡动脉AVF手术的尿毒症患者。手术过程中，以椭圆形切除10mm长的部分动脉壁用于显微镜分析。标本用三色染色法染色，并由对临床数据不知情的病理学家进行检查。然后在术后对AVF通畅情况进行1年的随访。在总共90例患者中，31例患者（34%）在术后1年内出现AVF失功。失功组（n = 31）的平均IMT比通畅组（n = 59）更厚（486±130微米 vs. 398±130微米，p = 0.004）。IMT≥500微米的患者（n = 26）术后1年内的AVF通畅率低于IMT＜500微米的患者（n = 64）（p = 0.017）。年龄是IMT的独立危险因素。糖尿病倾向于成为独立危险因素，但无统计学意义。我们的数据表明，HD患者桡动脉IMT增加与头静脉桡动脉AVF早期失功密切相关。
