动静脉内瘘血栓形成的危险因素及其与血清HMGB1、IL-1β、IL-10水平的关系  

Risk Factors for Thrombosis of Arteriovenous Fistulas and their Association with Serum HMGB1,IL-1β,and IL-10 Levels

作　　者：付勇超 FU Yong-chao(Kidney Disease Center,Yifu Hospital Affiliated to Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医科大学附属逸夫医院肾脏病中心,江苏南京211166

出　　处：《药物生物技术》2021年第6期611-614,共4页Pharmaceutical Biotechnology

摘　　要：探究动静脉内瘘(Arteriovenous Fistula,AVF)血栓形成的危险因素及其与血清高迁移率族蛋白B1(HMGB1)、白介素-1β(IL-1β)、白介素-10(IL-10)水平的关系。回顾性选择80例2019年3月~2020年6月于该院透析中心就诊的以自体动静脉内瘘为血管通路行维持性血液透析(MHD)的患者,根据是否AVF血栓形成分为血栓组(n=17)、非血栓组(n=63),收集两组的临床资料,并以多因素Logistic回归分析法分析MHD患者AVF血栓形成的危险因素,比较两组血清HMGB1、IL-1β、IL-10水平及其对AVF血栓的诊断效能。多因素Logistic回归分析结果显示,年龄≥60岁、透析后低血压、白蛋白<35 g/L、凝血状况为高凝状态、内瘘血管钙化均为患者AVF血栓形成的独立危险因素(OR=3.983,3.725,4.660,3.823,3.540,P<0.05)。血栓组血清HMGB1、IL-1β、IL-10水平高于非血栓组(P<0.05)。HMGB1、IL-1β、IL-10联合检测的诊断灵敏度为100.00%,高于各指标单独检测的82.35%、94.12%、94.12%(P<0.05)。AVF血栓形成的MHD患者血清HMGB1、IL-1β、IL-10水平较高,且各项指标联合诊断可提高诊断灵敏度,年龄≥60岁、透析后低血压、白蛋白<35 g/L、高凝状态、内瘘血管钙化均为MHD患者AVF血栓形成的独立危险因素,临床应强化内瘘保护意识,及时予以AVF血栓高风险人群针对性措施以降低MHD患者的AVF血栓发生率。To investigate the risk factors of thrombosis in arteriovenous fistula AVF and its relationship with serum levels of high mobility group protein B1(HMGB1),interleukin-1β(IL-1β),interleukin-10(IL-10),80 patients who underwent maintenance hemodialysis(MHD)using autogenous arteriovenous fistula as vascular access in the authors'dialysis center from March 2019 to June 2020 were retrospectively selected,and clinical data were collected from the two groups based on whether AVF thrombosis could be classified into thrombotic group(n=17),non thrombotic group(n=63),and the risk of AVF thrombosis in patients with MHD was analyzed by multivariate logistic regression analysis.Risk factors,serum HMGB1,IL-1β,IL-10 levels and their diagnostic efficacy for AVF thrombus were compared between the two groups.On multivariate logistic regression analysis,age≥60 years,post dialysis hypotension,albumin<35 g/L,coagulopathy with hypercoagulable hypercoagulable state,and vascular calcification of internal fistula were all independent risk factors for AVF thrombosis(OR=3.983,3.725,4.660,3.823,and 3.540,respectively,P<0.05).Serum HMGB1,IL-1β,and IL-10 levels were higher in the thrombus group than in the non thrombus group(P<0.05).The diagnostic sensitivity of the combined HMGB1,IL-1βand IL-10 assay was 100.00%,which was higher than the value of 82.35%,94.12%,94.12%for each index test alone(P<0.05).MHD patients with AVF thrombosis had higher serum levels of HMGB1,IL-1β,and IL-10,and the combined diagnosis of each index improved the diagnostic sensitivity,as indicated by age≥60 years,post dialysis hypotension,and albumin<35 g/L,hypercoagulable state,and vascular calcification of internal fistula were all independent risk factors for AVF thrombosis in MHD patients,awareness of internal fistula protection should be strengthened clinically,and population at high risk of AVF thrombus should be targeted timely to reduce the incidence of AVF thrombus in MHD patients.

关 键 词：动静脉内瘘 血栓 维持性血液透析 高迁移率族蛋白B1 白介素1Β 白介素10 危险因素 

分 类 号：R587[医药卫生—内分泌]