Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis.
Effects of percutaneous transluminal angioplasty and associated factors in access hand oxygenation in patients undergoing hemodialysis.
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DOI：
10.1038/s41598-023-29879-0
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发表时间：
2023-02-13
影响因子：
4.6
通讯作者：
Morishita Y
中科院分区：
文献类型：
--
作者：
Sugiyama T;Ito K;Ookawara S;Shimoyama H;Shindo M;Hirata M;Shimoyama H;Nakazato Y;Morishita Y
在患有动静脉瘘（AVF）的血液透析（HD）患者中，由于 AVF 的存在，全身或外周组织循环发生非生理性变化；然而，大脑和手部血流量与组织氧合之间的关系尚不确定。在这项研究中，纳入了 85 名患有 AVF 的 HD 患者，并评估了经皮腔内血管成形术 (PTA) 前后脑部和手部 AVF 的流量 (FV) 和局部氧饱和度 (rSO2) 的变化。此外，我们评估了决定 PTA 后入路手 rSO2 无狭窄的因素。 PTA 后肱动脉 FV 增加 (p < 0.001)，颈动脉 FV 下降 (p = 0.008)。 PTA 后手部 rSO2 显着下降（p<0.001），但脑 rSO2 没有显着变化（p=0.317）。在与介入手rSO2相关的因素的多变量线性回归分析中，提取血清肌酐（标准化系数：0.296）和血红蛋白（标准化系数：0.249）作为介入手rSO2的独立因素。总之，在整个 PTA 过程中观察到手部氧合下降和脑氧合维持下降。为了维持手部氧合，除了拥有适当血流的 AVF 之外，充分控制 Hb 水平并维持肌肉质量也很重要。
In hemodialysis (HD) patients with arteriovenous fistula (AVF), changes in systemic or peripheral tissue circulation occur non-physiologically via the presence of AVF; however, associations between blood flow and tissue oxygenation in the brain and access hand are uncertain. In this study, 85 HD patients with AVF were included and evaluated for changes in flow volume (FV) and regional oxygen saturation (rSO2) in the brain and hands with AVF before and after percutaneous transluminal angioplasty (PTA). Furthermore, we evaluated the factors that determine access hand rSO2 without stenosis after PTA. Brachial arterial FV increased after PTA (p < 0.001), and carotid FV decreased (p = 0.008). Access hand rSO2 significantly decreased after PTA (p < 0.001), but cerebral rSO2 did not significantly change (p = 0.317). In multivariable linear regression analysis of factors associated with access hand rSO2, serum creatinine (standardized coefficient: 0.296) and hemoglobin (standardized coefficient: 0.249) were extracted as independent factors for access hand rSO2. In conclusion, a decrease in access hand oxygenation and maintenance of cerebral oxygenation were observed throughout PTA. To maintain access hand oxygenation, it is important to adequately manage Hb level and maintain muscle mass, in addition to having an AVF with appropriate blood flow.
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影响因子：
3
作者：
Amerling, Richard;Ronco, Claudio;Winchester, James F.
通讯作者：
Winchester, James F.
影响因子：
1.9
作者：
Malik, Jan;Kudlicka, Jaroslav;Tesar, Vladimir
通讯作者：
Tesar, Vladimir
DOI：
10.1002/jcsm.13078
发表时间：
2022-12
期刊：
Journal of cachexia, sarcopenia and muscle
影响因子：
--
作者：
通讯作者：
--
影响因子：
3.7
作者：
Miyazawa H;Ookawara S;Ito K;Ueda Y;Yanai K;Ishii H;Mutsuyoshi Y;Kitano T;Shindo M;Aomatsu A;Hirai K;Hoshino T;Morishita Y
通讯作者：
Morishita Y
影响因子：
1.6
作者：
Lomonte, C;Casucci, F;Basile, C
通讯作者：
Basile, C