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肾脏病与透析肾移植杂志

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年龄是影响桡动脉-头静脉内瘘成熟的危险因素

  

  • 出版日期:2020-08-28 发布日期:2020-08-22

Increasing age related to reduce of primary functional maturation of wrist arteriovenous fistula

  • Online:2020-08-28 Published:2020-08-22

摘要: 目的:既往研究发现老年患者腕部桡动脉头静脉内瘘(RCAVF)成熟率较低,本文旨在分析年龄与内瘘成熟的相关性。
方法:回顾性队列研究265例RCAVF手术患者。术前超声测量血管内径,术后至少随访3个月。多变量Logistic回归分析影响RCAVF成熟的危险因素。将患者按年龄分为四组(≤29岁、30~49岁、50~69岁和70~89岁),经过多模型校正及P趋势检验,分析年龄增长与RCAVF不成熟风险的关系。
结果:术后4~6周按照腕部RCAVF是否达到成熟标准,将患者分成熟组218例,不成熟组47例。随年龄升高与成熟相关的OR值降低,多模型校正P趋势均<005。经多因素模型校正,年龄每增加20岁,不成熟的风险显著增加,所得的OR值均>16。
结论:腕部RCAVF的不成熟风险随着年龄的增加而显著增加。年龄与RCAVF功能成熟降低存在线性趋势。年龄每增加20岁,不成熟风险增加60%以上。

关键词: 腕部桡动脉-头静脉内瘘, 功能成熟, 年龄

Abstract: Objective:Previous studies have found the maturity rate of radiocephalic arteriovenous fistula(RCAVF) in elderly patients is low.The objective of the study was to perform trend analysis to verify relationship between increasing age and functional maturation of RCAVF.
Methodology:Our retrospective cohort study enrolled and analyzed 265 followup cases underging first AVF creation.The artery and vein sizes were measured by ultrasound.After surgery,we performed a followup minimum of 3 monthsMultivariable logistic regression analysis was to identify whether age was an independent risk factor of maturation.Participants were categorized into four groups(Age≤29y,30~49y,50~69y,and 70~89y)We adjusted  some confounders in four logistic models and primary analyses were based on building ordered age categories models and tested P values for trends to estimate the relationship between each 20 years increase in age and immaturity risk of RCAVF.
Results:46 weeks after the surgery,the  wrist RCAVF mature group included 218 cases,and immature group included 47 casesOdds ratios(OR)value associated with immaturity rate were reduced with increasing age,and P values for trend(<005) were all observed in four different models.Each 20 years increase in age was significantly associated with higher incidence of immaturity odds ratios(OR values more than 16) after adjusting multivariate models.The smooth curves for the relationship between increasing age and immaturity were shown.
Conclusion:
This study suggested that significantly higher immaturity risk of wrist RCAVF associated with exposure to age.Linear exposureresponse relations between age  and incident immaturity was proved.For every 20 years of age the risk of immaturity increases by more than 60%.

Key words: wrist radio-cephalic arteriovenous fistula, functional maturation, age