血液透析患者动静脉内瘘与心血管系统并发症

Arteriovenous fistulas and cardiovascular complication in hemodialysis patients

血管通路的选择对血液透析治疗至关重要,自体动静脉内瘘(AVF)可明显改善血液透析患者的生活质量。然而,由于终末期肾病患者心血管事件发生率高,包括左室肥大、容量负荷和内皮细胞功能紊乱等,在AVF建立后,使已经较为复杂的病理生理学变得更为复杂。AVF可引起心血管血流动力学包括体循环和肺循环的改变,导致了心脏结构、功能和肺循环的适应失调等,进而影响血液透析患者的心肺功能、生活质量和生存率。全面了解AVF对心血管系统的影响,可为AVF相关的心血管并发症的预防和治疗提供理论依据。

The choice of vascular access is crucial to hemodialysis（ HD） patients. A series of pathological and physiological changes occurred in patients with end stage renal disease,including cardiovascular such as left ventricular hypertrophy,volume overload,and endothelial dysfunction. The introduction of autologous arteriovenous fistula（ AVF）significantly improves the quality of life in HD patients. However,creation of AVF for HD imparts another degree of complexity to this already complex physiology. Aside from making obvious alterations in the vascular anatomy,AVF cause changes in cardiovascular hemodynamics,including the systemic and pulmonary circulations. Therefore,it is necessary to fully understand the effects of AVF on the cardiovascular system,and provide theoretical basis for the prevention and treatment of AVF related cardiovascular complications.