自体动静脉内瘘血栓形成危险因素分析

Analysis of risk factors of autologous internal arteriovenous fistula thrombosis

目的探讨自体动静脉内瘘血栓形成的危险因素。方法回顾性分析72例经自体动静脉内瘘维持性血液透析的终末期肾脏病患者的临床资料,按照是否在41个月的观察期内出现动静脉内瘘血栓分为血栓组及非血栓组,对两组的一般资料及生化指标进行比较分析。结果血栓组血清总胆固醇、低密度脂蛋白高于非血栓组,高密度脂蛋白低于非血栓组(P<0.05)。两组在糖尿病患病率、糖化血红蛋白、C-反应蛋白、血红蛋白、甘油三酯等方面差异无统计学意义。结论血清中总胆固醇、低密度脂蛋白、高密度脂蛋白水平与动静脉内瘘血栓形成具有相关性,糖尿病并非自体动静脉内瘘发生远期血栓的危险因素,对血脂异常进行早期干预可能会防止内瘘的血栓形成。

Objective To discuss the risk factors of autologous internal arteriovenous fistula thrombosis. Methods Retrospective analysis was made in the clinical data of 72 patients with final stage of renal diseases who received autologous internal arteriovenous fistula maintenance hemodialysis. They were divided into thrombotic group and non-thrombotic group according to their occurrence of thrombosis within the 41 months of observation period. Comparison and analysis were made in their general data and biochemical indicators. Results The levels of serum total cholesterol and low-density lipoprotein in the thrombotic group were significantly higher and high-density lipoprotein was significantly lower than those in the non-thrombotic group （ P 〈 0.05 ）. There was no significant difference in the morbidity of diabetes, glycosylated hemoglobin, C-reactive protein, hemoglobin, and triglyceride between the two groups. Conclusion There is a correlation between the levels of serum total cholesterol and low and high density lipoproteins and the thrombosis of internal arteriovenous fistula. Diabetes is not the risk factor of the thrombosis of autologous internal arteriovenous fistula. Early intervention of dyslipidemia may prevent the thrombosis in internal fistula.