RESUMEN
Objective To define a parameter of autologous arteriovenous fistula stenosis that limits the fistula function for hemodialysis in our country.Methods Retrospectively study the doppler ultrasound of patients who accepted the percutaneous transluminal angioplasty (PTA) therapy due to autogenous arteriovenous fistula dysfunction;identify the least diameter of the fistula vein and compare it with the corresponding data of well-functioned fistula.Determine which absolute diameter constitutes a hemodynamically significant stenosis in a radioeephalic autologous arteriovenous fistula by receiver operating characteristic curve (ROC curve).Result Forty-two patients were enrolled in the study.The average age of those patients was 54.63±2.44 years old.Twenty-one patients were female.Twenty-six fistula located on the left arm.The minimal diameter of the dysfunction fistula averaged 1.57±0.07 mm,while the average forearm fistula vein diameter was 4.04±0.23 mm,significantly smaller than those in the compare group-an average minimal fistula vein diameter of 3.34±0.11 mm and a forearm vein diameter of 5.36(4.52,6.45) mm (P ＜ 0.05).The control group contained sixty-eight patients.The average age of those patients was 52.56±2.00 years old.Thirty-one patients were female.Forty-nine fistula located on the left arm.It was quiet appropriate in using minimal diameter of the fistula vein to indicate the dysfunction istula with an under-curve area of 0.979,95％C1 0.959-0.998.The under-curve area would be at the largest level when meeting the cutoff point at 2.40mm,in which it could achieve the area of 0.853.Conclusions The minimal diameter of the dysfunction wrist autogenous arteriovenous fistula was much smaller than the functioned ones.Minimal diameter of the fistula vein may serve as an effective parameter in detecting dysfunction fistula.
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Objective To assess the value of thickness and arterial resistive index (RI) of wrist synovium in differentiation from activity to non-activity of rheumatoid arthritis (RA). Methods Ninety-two clinically confirmed RA patients underwent high frequency ultrasonography. Maximum thickness and arterial RI of the wrist synovium were measured in active and nonactive stage. Results Thickened synovium was found in 75 of 92 patients. Color signal in the synovium was detected and then RI was measured in 67 patients, including 31 in active stage and 36 in nonactive stage. The wrist synovium thickness of 67 patients was (2.97±1.49) mm and arterial RI was 0.74±0.17. RI decreased significantly in patients in active stage compared with that in nonactive stage (P<0.001). Conclusion Arterial RI measurement with high frequency ultrasonography may be served as an objective marker of synovial membrane disease in RA. The thickness of synovium cannot predict the activity of RA.