Clinical Study On Correlation Between Fingertip Oxygen Saturation And Dialysis Access-associated Steal Syndrome(dass)

Purpose To explore the relationship and correlation between fingertip oxygen saturation and dialysis access-associated steal syndrome（DASS）,and to find a means to assist in diagnosis and more earlier monitoring orscreening method,which is simple,inexpensive,non-invasive,green and low carbon and easy to be accepted by patients and medical staff.It helps to reduce the burden of disease and make more patients are benefited,so as to provide evidence for clinical work.Methods To select 480 patients with CKD by systematic sampling,who was in accordance with the criteria and dialysed in the Second Affiliated Hospital of Guangzhou Medical University from January 1,2017 to May 31,2017.And the patients in the symptomatic group are diagnosed by color Doppler ultrasonography.Collecting fingertip oxygen saturation,blood pressure,pulse,dialysis adequacy,HGB,ALB,P,PTH,Ca,CRP,UA and other data by using a cross-sectional survey method.To divide different groups for comparative analysisaccording to the clinical symptoms and signs of DASS and whether or not the internal fistula fingertip oxygen saturation is abnormal.Multiple factors were analyzed by logistics stepwise regression analysis,with p<0.05,and the difference was statistically significant.Results There was a difference inInternal fistula fingertip oxygen saturation between the three groups（p<0.05）.With the increase of the symptom level of DASS,the fingertip oxygen saturation decreased continuously in the asymptomatic group（97.12±2.26）%,the first class symptom group（93.54±1.92）%,and the grade two or three（89.23±3.17）%.There was a statistically significant difference between the three groups and the each other two groups（p<0.05）.The absolute value of the correlation coefficient R was more than 0.4 in the rank correlation analysis,and there was a linear correlation between the fingertip oxygen saturation（Y）and the DASS symptom level（X）（p<0.05）.In the Logistic regression analysis,each increasing one level of DASS symptom,and the possibility of the internal fistula fingertip oxygen saturation was 20.865 times lower than the normal value（94%）as low as that of the lower one.The DASS of patients with systolic blood pressure had a lower than 94%of fingertip oxygen saturation,which was 4.236 times higher than that of DASS patients with elevated systolic blood pressure.Conclusion There was no significant difference and correlation between the contralateral finger oxygen saturation and the level of DASS symptom.There was a difference inInternal fistula fingertip oxygen saturation between the three groups（p<0.05）.With the increase of the level of DASS symptom,the fingertip oxygen saturation decreased continuously,there is a linear correlation between them.The Logistic of the internal fistula fingertip oxygen saturation was calculated by stepwise regression equation:Logit（p）=-6.083+3.038X₄+1.444X₅-1.299X₉（X₄was assigned to the symptom grade of DASS:asymptomatic group=1,first class symptom group=2,grade two or three class symptom group=3;X₅ was systolic pressure assignment:<140mmHg=1,≥140mmHg=2;X₉ as PTH:≤71pmol/L=1,>71pmol/L=2）.