半永久双腔中心静脉导管维持性血液透析患者的微炎症状态  

Effect of semi-permanent double-lumen central venous catheter on micro-inflammatory state in maintenance hemodialysis patients

作　　者：张晓东[1] 李小萍[2] 宋洁[1] 李瑛[1] 李辉[1] 

机构地区：[1]武警后勤学院附属医院肾脏病科,天津市300162 [2]武警医学编辑部,北京市100039

出　　处：《中国组织工程研究》2013年第5期913-919,共7页Chinese Journal of Tissue Engineering Research

基　　金：天津市自然科学基金资助项目(09JCYBJC09900)~~

摘　　要：背景:半永久性双腔中心静脉导管作为自体动静脉内瘘的重要补充形式在维持性血液透析患者中应用日益广泛,但有研究发现,将半永久性双腔中心静脉导管作为血液透析血管通路患者的死亡率高于使用自体动静脉内瘘者,原因尚未完全明确。目前不同类型血管通路对微炎症状态的影响还鲜有报道。目的:比较半永久性双腔中心静脉导管与自体动静脉内瘘作为血管通路维持性血液透析患者体内炎性因子的差异,探讨不同类型的血管通路对维持性血液透析患者微炎症状态的影响。方法:选择维持性血液透析患者80例,根据血管通路不同分为自体动静脉内瘘组48例及颈静脉半永久双腔静脉导管组32例,以门诊健康体检者60例作为健康对照。检测2组维持性血液透析患者及健康对照者血清超敏C-反应蛋白、白细胞介素6、肿瘤坏死因子α水平,并行对比分析。结果与结论:维持性血液透析患者血清超敏C-反应蛋白、白细胞介素6、肿瘤坏死因子α水平明显高于健康对照组,差异有显著性意义(P<0.01);半永久插管组患者血清超敏C-反应蛋白、白细胞介素6、肿瘤坏死因子α水平高于内瘘组,差异有显著性意义(P<0.05)。结果提示维持性血液透析患者体内存在微炎症状态,使用半永久性双腔中心静脉导管作为血液透析血管通路较使用自体动-静脉内瘘可进一步加重微炎症状态。BACKGROUND： Semi-permanent double-lumen central venous catheter as an important supplement of autogenous arteriovenous fistula has been widely used in maintenance hemodialysis patients. But the studies have found that the mortality rate of semi-permanent double-lumen central venous catheters used for hemodialysis vascular access is higher than that of autogenous arteriovenous fistula. The reason is not clear. At present, the effect of different types of vascular access on the micro-inflammatory state is rarely reported. OBJECTIVE： To compare the different levels of inflammation factors in maintenance hemodialysis patients with semi-permanent double-lumen central venous catheter and arteriovenous fistula, and to explore the effect of the hemodialysis vascular access types on the micro-inflammation in maintenance hemodialysis patients. METHODS： Eighty patients with uremia underwent maintenance hemodialysis were selected, and divided into autologous arteriovenous fistula group （n=48） and semi-permanent double-lumen central venous catheter group （n=32） according to different vascular access types. Sixty healthy people were selected as normal control group. The serum high sensitivity C-reactive protein, interleukin-6 and tumor necrosis factor-α of the maintenance hemodialysi group and the normal control group were detected. RESULTS AND CONCLUSION： The serum high sensitivity C-reactive protein, interleukin-6 and tumor necrosis factor-α of the maintenance hemodialysis patients were significantly higher than those of the normal control group （P 0.01）. The serum high sensitivity C-reactive protein, interleukin-6 and tumor necrosis factor-α in the semi-permanent double-lumen central venous catheter group were higher than those in the autologous arteriovenous fistula group （P 0.05）. Micro-inflammatory state exists in maintenance hemodialysis patients, and the utilization of semi-permanent double-lumen central venous catheter as hemodialysis vascular access can aggravate the micro- inflammatory sta

关 键 词：器官移植 器官移植基础实验 半永久性双腔中心静脉导管 自体动静脉内瘘 维持性血液透析 健康对照 炎性因子 超敏C-反应蛋白 白细胞介素6 肿瘤坏死因子α 微炎症状态 省级基金 

分 类 号：R318[医药卫生—生物医学工程]