血浆同型半胱氨酸与血液透析患者动静脉内瘘狭窄的关系  

The relationship between plasma homocysteine and stenosis of internal arteriovenous fistula in maintenance hemodialysis patients

作　　者：陈卫东 张燕[1] 常保超[1] 杨萍[2] 

机构地区：[1]安徽省蚌埠医学院第一附属医院肾病科,蚌埠233004 [2]安徽省蚌埠医学院第一附属医院检验科,蚌埠233004

出　　处：《中国血液净化》2009年第6期319-321,共3页Chinese Journal of Blood Purification

基　　金：安徽省教育厅自然科学基金资助项目(2005kj290)

摘　　要：目的观察持性血液透析患者血浆同型半胱氨酸水平的变化,分析同型半胱氨酸与动静脉内瘘狭窄的关系。方法将使用自体动静脉内瘘维持性血液透析超过3 月的101 例患者分为两组:动静脉内瘘狭窄组37例,动静脉非狭窄组64例;分别比较上述两组患者的平均血液透析时间、透析超滤量(UV)、平均动脉压(MAP)、血清肌酐(Scr)、三酰甘油(TG)、胆固醇(CHO)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血总蛋白(TP)、白蛋白(ALB)、血红蛋白(Hb)、红细胞压积(Hct)、同型半胱氨酸(Hcy)等指标。结果动静脉内瘘狭窄组的血浆同型半胱氨酸明显高于非狭窄组(P <0.01),此外,动静脉内瘘狭窄组长期口服叶酸、VitB6 例数明显低于动静脉内瘘非狭窄组(P <0.05),动静脉内瘘狭窄组患者平均透析时间、透析超滤量、平均动脉压、Scr、TG、CHO、HDL、LDL、TP、ALB、Hb、Hct等与动静脉内瘘非狭窄组无显著差异(P > 0.05)。结论同型半胱氨酸与动静脉内瘘狭窄有关,长期口服叶酸、维生素B6 能减低动静脉的狭窄。Objective To investigate the change of plasma homocysteine, and to analyze the relationship between plasma homocysteine and the stegnosis of internal arterovenous fistula in maintenance hemodialysis patients. Methods We divided 101 hemodialysis patients with internal arteriovenous fistula for more than 3 months into two groups： stenosed arteriovenous fistula group （stenosed group, 37cases） and non-stenosed arteriovenous fistula group （non-stenosed group, 64 cases）. The mean hemodialysis time, mean arterial pressure, ultrafiltration volume, and serum creatinine, triglyceride, cholesterol, high density lipoprotein, total protein, albumin and homocysteine were examined. Results In stenosed group, plasma homocysteine was significantly higher than that of the non-stenosed group （P〈0.01）. The ratio of patients receiving folic acid and vitamin B6 treatment was less in stenosed group than in non-stenosed group （P 〈 0.05）. No significant differences in mean hemodialysis time, mean arterial pressure, serum creatinine, total protein, albumin were found between the two groups. Conclusions Homocysteine seems to induce the stenosis of internal arteriovenous fistula in maintenance hemodialysis patients. Administration of folic acid and vitamin B6 may reduce the risk of arteriovenous fistula stenosis.

关 键 词：血液透析 动静脉内瘘 同型半胱氨酸 叶酸 维生素B6 

分 类 号：R318.16[医药卫生—生物医学工程]