高通量透析对维持性血液透析患者自体动静脉内瘘7年次级通畅率的影响

孙春艳; 宋利; 莫雅文; 周丽芳; 郑淑倩; 陈迎归; 符霞

doi:10.3969/j.issn.1671-4091.2020.03.011

中国血液净化 >

2020 , Vol. 19 >Issue 03: 187 - 190

DOI: https://doi.org/10.3969/j.issn.1671-4091.2020.03.011

血管通路

高通量透析对维持性血液透析患者自体动静脉内瘘7年次级通畅率的影响

孙春艳 ,
宋利 ,
莫雅文 ,
周丽芳 ,
郑淑倩 ,
陈迎归 ,
符霞

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1 南方医科大学护理学院
2广东省人民医院(广东省医学科学院)肾内科血液净化中心
3 广州市第一人民医院南沙医院肾内科

收稿日期: 2019-12-12

修回日期: 2019-12-30

网络出版日期: 2020-03-12

基金资助

中央高校基本科研业务费专项资金资助(2018MS24)；广东省科技计划项目(2015A020210071)

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Impact of high-flux dialysis on 7-year secondary patency rate of autologous arteriovenous fistula in hemodialysis patients

SUN Chun-Yan ,
SONG Li ,
MO Ya-Wen ,
ZHOU Li-Fang ,
ZHENG Shu-Qian ,
CHEN Ying-Gui ,
FU Xia

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1 School of Nursing, Southern Medical University, Guangzhou 510515, China;
2 Hemodialysis Center, Department of Nephrology, Guangdong Provincial People’s Hospital / Guangdong Academy of Medical Sciences, Guangzhou 510080, China; 3 Division of Nephrology, Guangzhou Nansha Central Hospital, Guangzhou 511457, China

Received date: 2019-12-12

Revised date: 2019-12-30

Online published: 2020-03-12

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摘要

【摘要】目的探讨高通量透析方式对维持性血液透析患者自体动静脉内瘘使用寿命的影响。方法分析2012～2019 年于广东省人民医院血液净化中心规律透析治疗的患者491 例。采用倾向评分匹配法1：1 匹配高通组和低通组各54 例患者，比较2 组患者自体动静脉内瘘的7 年次级通畅率。结果 Kaplan-Meier生存分析提示高通组和低通组患者自体动静脉内瘘的7年次级通畅率无统计学差异[匹配前: 87.9%和84.3%，HR(95% CI) = 0.834 (0.449～1.548)，P = 0.566；匹配后：91.2%和82.1%，HR(95% CI) = 0.836 (0.224～3.120)，P = 0.790]。结论高通量透析模式对维持性血液透析患者自体动静脉内瘘的使用寿命无显著影响。

关键词： 高通量透析; 自体动静脉内瘘; 维持性血液透析; 次级通畅率

本文引用格式

孙春艳 , 宋利 , 莫雅文 , 周丽芳 , 郑淑倩 , 陈迎归 , 符霞 . 高通量透析对维持性血液透析患者自体动静脉内瘘7年次级通畅率的影响[J]. 中国血液净化, 2020 , 19(03) : 187 -190 . DOI: 10.3969/j.issn.1671-4091.2020.03.011

Abstract

【Abstract】Objective This study was conducted to investigate the impact of high-flux dialysis on lifespan of the autologous arteriovenous fistula in patients undergoing maintenance hemodialysis (MHD). Methods A total of 491 patients with regular hemodialysis at the Blood Purification Center of Guangdong Provincial People's Hospital from 2012 to 2019 were enrolled in this study. The propensity score matching method matched high-flux dialysis group (n=54) and low-flux dialysis group (n=54). The 7-year secondary patency rate of arteriovenous fistula was compared between the two groups. Results Kaplan-Meier survival analysis

showed no statistical difference in the 7-year secondary patency rate of autologous arteriovenous fistula between high- flux dialysis group and low- flux dialysis group [before matching: 87.9% vs. 84.3%, HR (95% CI) =0.834 (0.449~1.548), P=0.566; after matching: 91.2% vs. 82.1%, HR (95% CI) =0.836 (0.224~3.120), P=0.790]. Conclusion The high- flux dialysis mode had no significant impact on the lifespan of arteriovenous fistula in MHD patients.

Key words： High- flux dialysis; Arteriovenous fistula; Maintenance hemodialysis; Secondary patency rate

参考文献

[1].参考文献 [2] Chinese National Renal Data System[EB/OL].http://www.cnrds.net/Pages/Home. [3]Nkfkw G.KDOQI clinical practice guidelines and clinical practice recommendations for vascular access[J].Am J Kidney Dis, 2006, 48(Suppl 1):S176-S322 [4]金其庄, 王玉柱, 叶朝阳, 等.中国血液透析用血管通路专家共识第版[J].中国血液净化, 2019, 18(06):365-381 [5]周乐天, 刘虹, 刘伏友, 等.例自体动静脉内瘘的生存分析和影响因素[J].中南大学学报医学版, 2015, 40(08):902-906 [6]杨雪群, 邓兆燕, 陈梅.血液透析动静脉内瘘堵塞发生时间及相关因素分析[J].护理研究, 2017, 31(30):3891-3893 [7] 黄明俊.单中心自体动静脉内瘘晚期失功危险因素分析[D]. 南昌大学, 2018. [8] 朱文景.膜通透量不同对慢性肾衰竭患者血液透析效果的meta分析[D]. 重庆医科大学, 2016. [9]熊良伟, 张祥贵.成熟自体动静脉内瘘失功的慢性危险因素研究[J].中国血液净化, 2018, 17(05):329-334 [10] 王质刚.血液净化学（第4版）[M]. 第4版. 北京:北京科学技术出版社, 2016. [11] 王超.158例次人工血管动静脉内瘘术后并发症与长期通畅率[D]. 重庆医科大学，2017. [12]Venu Manne S P V V.Factors Influencing Patency of Brescia-Cimino Arteriovenous Fistulas in Hemodialysis Patients[J].Saudi J Kidney Dis Transpl, 2017, 28(2):313-317 [13]王博, 魏芳, 孙桂江, 等.维持性血液透析患者自体动静脉内瘘使用时间及其影响因素研究[J].中国全科医学, 2018, 21(29):3577-3581 [14]程博娅.维持性血液透析患者自体动静脉内瘘失功的影响因素分析[J].中国现代药物应用, 2018, 12(20):19-21 [15]Stolic R V, Jovanovic A N, Trajkovic G Z, et al.Is low magnesium a clue to arteriovenous fistula complications in hemodialysis?[J].International Urology and Nephrology, 2016, 48(5):773-779 [16]彭小梅, 刘园园, 吴潮清, 等.维持性血液透析患者自体动静脉内瘘失功的危险因素研究[J].中国全科医学, 2017, 20(01):67-70 [17]Salmela B, Hartman J, Peltonen S, et al.Thrombophilia and Arteriovenous Fistula Survival in ESRD[J].Clinical Journal of the American Society of Nephrology, 2013, 8(6):962-968 [18]Fadel F I M A.Levels of cystatin C in low- and high-flux hemodialysis in children with end-stage renal disease[J].Pediatr Nephrol, 2017, 32(9):1603-1609 [19]陈伟, 马良, 周莉, 等.高通量血液透析临床应用、并发症及其治疗进展[J].海南医学院学报, 2018, 24(17):1619-1622 [20]Besarab A, Pandey R.Catheter management in hemodialysis patients: delivering adequate flow[J].Clin J Am Soc Nephrol, 2011, 6(1):227-234 [21]莫雅文, 宋利, 韩晓苇, 等.血液透析治疗中泵前动脉压与泵控血流量比值的临床研究[J].中国血液净化, 2019, 18(8):579-581 [22]郝立松, 曹道白音, 王青云, 等.球囊扩张血管成形术治疗自体动静脉内瘘狭窄临床分析[J].中国医刊, 2019, 54(09):1009-1011 [23] 应丽红.不同血液透析方式对尿毒症患者钙磷代谢影响的研究[J].中国基层医药, 2018, 3(25):318-321 [24]罗进辉, 张慧, 童运涛, 等.高通量血液透析对尿毒症患者不宁腿综合征及钙磷代谢的影响[J].湖南师范大学学报医学版, 2019, 16(03):82-84 [25]殷玉棉.高通量透析对维持性血液透析患者钙磷代谢的影响[J].当代医学, 2019, 25(09):135-137 [26]许树根, 李彩凤, 沈淑琼, 等.维持性血液透析患者微炎症状态与动静脉内瘘失功的关系[J].临床军医杂志, 2013, 41(08):789-790 [27]Wilson A M E A.Beta2-microglobulin as a biomarker in peripheral arterial disease: proteomic profiling and clinical studies[J].Circulation, 2007, 12(116):1396-1403 [28] 李彩凤.维持性血液透析患者动静脉内瘘栓塞影响因素的1:2匹配病例对照研究[D]. 安徽医科大学, 2013.

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