关键词: 维持性血液透析, 动静脉内瘘, 冠脉钙化评, 分经皮腔内血管成形术

Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore the risk factor of arteriovenous fistula (AVF) dysfunction and recurrent failure after percutaneous transluminal angioplasty (PTA) in maintenance hemodialysis (MHD) patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：The crosssectional study selected 131 MHD patients with autologue AVF were first established, in the Blood Purification Center of Huashan Hospital affiliated to Fudan University from January 2020 to December 2020. The retrospective cohort study included 30 patients who had experienced an fistula failure and received PTA from January 2015 to December 2020. Logistic regression, KaplanMerier, Log rank tests and Cox proportional hazard model were used to perform analysis.
Ｒｅｓｕｌｔｓ：Multivariate regression showed body mass index (BMI) (OR=0570, 95％CI 0375~0867, P=0009), serum β2 microglobulin level (OR=1106, 95％CI 1001~1221, P=0048) and hypotension (OR=20422, 95％CI 1607~259529, P=0020) were the risk factors for fistula dysfunction. The proportion of MHD patients with recurrent AVF failure after PTA was significantly higher in calcification score≥100 (5330％ vs. 1330％, P=0020). After adjusted for age, gender, dialysis vintage, diabetes and anastomosis, calcification score≥100 was an independent risk factor for recurrent AVF failure after PTA in MHD patients.
Ｃｏｎｃｌｕｓｉｏｎ：BMI, serum β2 microglobulin, and hypotension were the risk factors for the occurrence of AVF dysfunction, and vascular calcification was an independent risk factor for recurrent AVF failure.

Key words: maintenance hemodialysis, arteriovenous fistula, vascular calcification, percutaneous tansluminal angioplasty