Diagnostic value of serum β2-microglobulin level for arteriovenous fistula dysfunction in patients with uremia undergoing maintenance hemodialysis
Aim:To explore the diagnostic value of serum β2-microglobulin(β2-MG)level for arteriovenous fistula(AVF)dysfunction in patients with uremia undergoing maintenance hemodialysis(MHD).Methods:Totally 202 patients who were treated with MHD by taking AVF as vascular access in our hospital from January 2019 to April 2022 were select-ed.According to the function of AVF,the patients were allocated into dysfunction group(n =48)and control group(n = 154).The peripheral blood sample was collected and serum β2-MG was determined by Immulite 2000 automatic chemilumi-nescence immunoassay analyzer,and other indexes such as plasma high-sensitivity C-reactive protein(hs-CRP),D-dimer,etc were determined.Brachial artery Doppler ultrasound examination was performed,the vascular wall calcification and thrombosis were observed,and brachial artery blood flow volume,the brachial artery pulsatility index,resistance index were calculated.Logistic regression analysis was used to study the influencing factors of AVF dysfunction.ROC curve was drawn to analyze the diagnostic value of β2-MG on AVF dysfunction.Results:The levels of plasma hs-CRP,D-dimer and serum β2-MG in dysfunction group were higher than those in control group(P<0.05).The brachial artery blood flow volume in dysfunction group was less compared with that in control group,while the brachial artery pulsatility index,resistance index and incidence rates of vascular wall calcification and thrombosis were higher(P<0.05).Logistic regressionanalysisshowed that serum β2-MG,brachial artery blood flow volume and resistance index were the influencing factors of AVF dysfunction[OR(95%CI)were 1.446(1.211-1.726),0.994(0.991-0.996),1.158(1.034-1.298),all P<0.05].The area under curve(95%CI)of serum β2-MG in diagnosing AVF dysfunction in patients with uremia undergoing MHD was 0.705(0.654-0.864),and the sensitivity and specificity were 0.75 and 0.63 with the cutoff value of 15.81 mg/L.Conclu-sion:Serum β2-MG level is an important influencing factor of AVF dysfunction in uremic patients with MHD,and has cer-tain reference value on judging AVF dysfunction.
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