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不同血管通路对维持性血液透析患者相关指标的影响

Effect of different vascular access on related indicators in maintenance hemodialysis patients

    摘要
  • 摘要:
      目的  探讨不同血管通路对维持性血液透析患者相关指标的影响。
      方法  选取维持性血液透析患者96例, 根据血管通路的不同分为颈内静脉带袖套隧道导管(CTC)组、中心静脉置管(CVC)组、自体动静脉瘘(AVF)组，各32例。比较3组的C反应蛋白(CRP)、血红蛋白(Hb)、血清白蛋白(ALB)、白细胞介素-6(IL-6)、血磷、血钙、促红细胞生成素(EPO)、血清前白蛋白(PA)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)、总胆固醇(TC)指标水平以及左心室舒张功能障碍、左心室收缩功能障碍、左心室肥厚的发生情况、并发症发生情况。
      结果  AVF组CRP、IL-6水平显著低于CVC组、CTC组(P < 0.05), AVF组Hb、ALB水平显著高于CVC组、CTC组(P < 0.05); AVF组心室舒张功能障碍、左心室收缩功能障碍、左心室肥厚的发生率显著低于CVC组、CTC组(P < 0.05); AVF组血磷、血钙、EPO水平显著低于CVC组、CTC组(P < 0.05); AVF组PA水平显著高于CVC组、CTC组(P < 0.05); AVF组LDL、TG、TC水平显著低于CVC组、CTC组(P < 0.05); AVF组HDL水平显著高于CVC组、CTC组(P < 0.05); AVF组并发症发生率显著低于CVC组、CTC组(P < 0.05)。
      结论  维持性血液透析治疗中，AVF血管通路的效果更好，对患者微炎症因子指标的影响更小。

     

    Abstract:
      Objective  To investigate the effect of different vascular access on related indicators in maintenance hemodialysis patients.
      Methods  Ninety-six patients with maintenance hemodialysis were divided into internal jugular vein with cuff tunnel catheter (CTC) group, central venous catheter (CVC) group, and autologous arteriovenous fistula (AVF) group according to different vascular access. C reactive protein (CRP), hemoglobin (Hb), serum albumin(ALB), interleukin-6 (IL-6), serum phosphorus, blood calcium, erythropoietin (EPO), serum prealbumin (PA), low density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), total cholesterol (TC) levels, left ventricular diastolic dysfunction, left ventricular systolic dysfunction, and incidences of left ventricular hypertrophy as well as complications were compared.
      Results  The levels of CRP and IL-6 in AVF group were significantly lower than those in CVC group and CTC group (P < 0.05). The levels of Hb and ALB in AVF group were significantly higher than those in CVC group and CTC group (P < 0.05). Ventricular diastolic dysfunction, left ventricular systolic dysfunction and the incidence of left ventricular hypertrophy in AVF group were significantly lower than that of CVC group and CTC group (P < 0.05). The levels of serum phosphorus, serum calcium and EPO in AVF group were significantly lower, and PA level was significantly higher than that in CVC group and CTC group (P < 0.05). The levels of LDL, TG and TC in AVF group were significantly lower than those in CVC group and CTC group (P < 0.05). The HDL level in AVF group was significantly higher than that in CVC group and CTC group (P < 0.05); the incidence of complications in the AVF group was significantly lower than that in the CVC group and the CTC group (P < 0.05).
      Conclusion  The vascular access of AVF in maintenance hemodialysis has better efficacy, which has less influence on microinflammation factors.

     

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