【摘要】：目的探討尿毒癥自體動靜脈內(nèi)瘺(AVF)失功患者血漿可溶性內(nèi)皮細胞蛋白C受體(sEPCR)水平變化及其臨床意義。方法選擇經(jīng)橈動脈-頭靜脈吻合內(nèi)瘺行規(guī)律血液透析治療的尿毒癥患者42例,其中內(nèi)瘺失功21例(失功組)、內(nèi)瘺通暢21例(通暢組);失功組均給予內(nèi)瘺介入治療,術后18例AVF通暢。失功組術前及術后2個月、通暢組于透析前分別檢測血漿CRP、纖維蛋白原(FIB)、sEPCR水平及WBC計數(shù),分析內(nèi)瘺失功者血漿sEPCR水平與血漿CRP、FIB水平和WBC計數(shù)的關系。結(jié)果失功組術前血漿CRP、sEPCR水平均高于通暢組(P均0.05),兩組血漿FIB水平及WBC計數(shù)比較P均0.05。失功組內(nèi)瘺介入治療成功者治療后血漿CRP、sEPCR水平均低于治療前(P均0.05),治療前后血漿FIB水平及WBC計數(shù)比較P均0.05。失功組血漿sEPCR水平與血漿CRP水平呈正相關關系(r=0.715,P0.05),與血漿FIB水平和WBC計數(shù)無相關性(P均0.05)。結(jié)論尿毒癥AVF失功者血漿sEPCR水平升高,其水平變化可能參與內(nèi)瘺失功的形成;介導炎癥反應、促進血栓形成可能是其作用機制。
[Abstract]:Objective to investigate the changes and clinical significance of plasma soluble endothelial cell protein C receptor (sEPCR) in patients with autogenous arteriovenous fistula (AVF) failure in uremia. Methods Forty-two patients with uremia treated by regular hemodialysis via radial arterio-cephalic vein anastomosis were selected, including 21 cases of internal fistula failure group and 21 cases of internal fistula patency group, all of which were given interventional treatment of internal fistula. Postoperative AVF was patency in 18 cases. Before and 2 months after operation, plasma CRP, fibrinogen (FIB), EPCR and WBC count were detected in patency group before dialysis. The relationship between plasma sEPCR level and plasma CRP FIB and WBC count in patients with internal fistula failure was analyzed. Results the levels of FIB and WBC in the two groups were significantly higher than those in the unobstructed group before operation (P 0.05). The plasma levels of CRP FIB and WBC in the patients with internal fistula were lower than those before treatment (P 0.05), and the levels of plasma FIB and WBC before and after treatment were all lower than those before and after treatment (P 0.05). There was a positive correlation between plasma sEPCR level and plasma CRP level in dysfunctional group (r = 0.715 P 0.05), but no correlation with plasma FIB level and WBC count (P 0.05). Conclusion the level of plasma sEPCR in uremic patients with AVF dysfunction may be involved in the formation of internal fistula and may be involved in the formation of internal fistula, mediating inflammatory reaction and promoting thrombosis may be the mechanism of its action.
【作者單位】： 南通大學第二附屬醫(yī)院;南通大學附屬醫(yī)院;
【分類號】：R692.5

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