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自体动静脉内瘘反复功能丧失患者血小板功能分析

吴建华1,施辉2,3,王锋2,3,张义德2,4   

  1. 1. 江苏省南通大学附属医院
    2.
    3. 南通大学附属医院肾内科
    4. 南通大学附属医院肾内ke
  • 收稿日期:2010-10-26 修回日期:2011-04-11 出版日期:2011-09-15 发布日期:2011-09-15
  • 通讯作者: 吴建华

Effects of Platelet Factors on Haemodialysis Patients with Recurrent Native Arteriovenous Fistula Dysfunction

  • Received:2010-10-26 Revised:2011-04-11 Published:2011-09-15 Online:2011-09-15

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摘要： 目的：探讨维持性血液透析患者自体动静脉内瘘反复功能丧失与血小板活化及聚集功能的关系。方法：选取我院血液净化中心维持性血液透析的终末期肾病患者为研究对象，分为自体动静脉内瘘反复功能丧失组（A组，18例）、自体动静脉内瘘长期存活组（B组，30例）。另设健康对照组（C组，12例）。采用流式细胞仪测定各组血小板活化指标（CD62P，CD63）的表达，同时分别以腺苷二磷酸 (ADP)和花生四烯酸(AA)为诱导剂光学法检测血小板聚集率(PAgT)，并进行组间比较。结果：与内瘘长期存活组及对照组相比，内瘘反复功能丧失组的血小板活化指标（CD62P和CD63）以及血小板聚集率（PAgTAD和PAgTAA）明显增高(P <0.05或P <0.01)。Logistic回归分析显示血小板CD62P表达增加及PAgTADP增高为自体动静脉内瘘反复功能丧失的危险因素。结论：维持性血液透析患者自体动静脉内瘘反复功能丧失与其循环的活化血小板水平增高及血小板聚集功能增强相关。

关键词: 自体动静脉内瘘, 血小板活化, 血小板聚集, 血液透析

Abstract: Objective：To investigate the relationship between platelet Factors and recurrent native AVF dysfunction in MHD(maintenance hemodialysis) patients．Methods：The studied subjects were divided into three groups(group A included 18 MHD patients with recurrent native AVF dysfunction, group B included 30 MHD patients with longer native AVF survival and group C included 12 healthy volunteers as controls). The expression of platelet activation markers(CD62P，CD63) were measured by flow cytometry（FCM）, and all studied subjects were detected platelet aggregation indued by arachidonic acid(AA) and adenosine diphosphate(ADP). All those results were compared among groups．Results：The level of activated platelet and platelet aggregation in group A is much higher than in group B and group C(P <0.05 or P <0.01). The logistic analysis showed that CD62P and PAgTADP were the risk factors of recurrent native AVF failure. Conclusion： The higher level of platelets activating and platelet aggregation is associated with recurrent native AVF dysfunction in MHD patients

Key words: native arteriovenous fistula, platelet activation, platelet aggregation, hemodialysis