炎症状态与血透用自体动静脉内瘘血栓形成的相关研究

Related Research between Inflammatory State andArteriovenous Fistulas Thrombosis

目的:观察炎症指标在血液透析用自体动静脉内瘘(AVF)血栓形成过程中的变化,探讨炎症状态在AVF血栓形成过程中的作用。方法:慢性肾衰竭(CRF)AVF术后患者77例按照是否出现内瘘血栓分为:内瘘通畅组(通畅组,n=60),内瘘血栓组(血栓组,n=17),分别比较上述两组患者与炎症状态相关的指标:高敏C反应蛋白(hsCRP)、单核细胞趋化蛋白-1(MCP-1)、可溶性内皮细胞蛋白C受体(sEPCR)、白细胞(WBC)、白蛋白(ALB)、纤维蛋白原(FIB)水平等指标。结果:与通畅组比较,血栓组hsCRP、MCP-1、FIB的水平升高,差异有统计学意义(P<0.05或0.01);血栓组与通畅组比较,前者血浆sEPCR的含量均值及平均秩次高于后者,差异虽无统计学意义(P>0.05),但P值已非常接近0.05,可能与本组样本量少有关;血栓组与通畅组比较,ALB水平、WBC水平差异无统计学意义(P>0.05)。结论:内瘘血栓形成时多种炎症指标升高,提示AVF血栓形成有炎症参与,炎症状态可能是AVF血栓形成的诱发因素,进而可能主动参与了血栓形成的过程。

Objective：To investigate the changes of inflammation markers in CRF patients with native arteriovenous fistulas （AVF） thrombosis,and to explore the relationship between inflammation and AVF thrombosis.Methods：Seventy-seven Chronic renal failure （CRF） patients with AVF were divided into two groups according to whether with thrombosis：control group （n=60） and thrombosis group （n=17）,compare the inflammation markers of the patients in two groups respectively：High sensitivity C-reactive protein （hsCRP）, Monocyte chemoattractant protein -1 （MCP-1）, Soluble endothelium protein C receptor （sEPCR）, leukocyte （WBC）, albumin （ALB）, fibrinogen （FIB） and other general data.Results：Compared with control group, relative amount of hsCRP,MCP-1,FIB were significantly increased in thrombosis group （P〈0.01）;the average amount and the mean rank order of sEPCR in thrombosis group were higher than in control group, there were no significant difference （P〉0.05）, but P value was very close to 0.05;and there were no significant difference of ALB, WBC between the two groups （P〉0.05）.Conclusion：A variety of inflammatory markers increased when AVF thrombosis,that indicating inflammatory state participate in the process of AVF thrombosis. Inflammatory state may be a predisposing factor of AVF thrombosis, furthermore, which also may be an active participant.