中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (08): 609-611,640.doi: 10.3969/j.issn.1671-4091.2024.08.008

• 综述 • 上一篇    下一篇

自体动静脉内瘘狭窄机制的研究进展

梁心议   王桃霞    刘晓丽    荣 丹   蔡晓贝   李桂英   

  1. 056004 邯郸，1河北工程大学临床医学院
    056004 邯郸，2河北工程大学附属医院肾内科
  • 收稿日期:2024-04-17 修回日期:2024-05-15 出版日期:2024-08-12 发布日期:2024-08-12
  • 通讯作者: 李桂英 E-mail:fflgy@126.com
  • 基金资助:
    河北省财政厅河北省卫生健康委关于确定2024年政府资助临床医学优秀人才培养项目(ZF2024204)

Research advances in  the mechanism of autogenous arteriovenous fistula stenosis

LIANG Xin-yi, WANG Tao-xia, LIU Xiao-li, RONG Dan, CAI Xiao-bei, LI Gui-ying   

  1. College of Clinical Medicine, Hebei University of Engineering, Handan 056004, China; 2Department of Nephrology, The Affiliated Hospital of Hebei University of Engineering, Handan 056004, China
  • Received:2024-04-17 Revised:2024-05-15 Online:2024-08-12 Published:2024-08-12
  • Contact: 056004 邯郸，2河北工程大学附属医院肾内科 E-mail:fflgy@126.com

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摘要： 自体动静脉内瘘(arteriovenous fistula，AVF)是血液透析(hematodialysis，HD)患者最常用的血管通路。临床上患者发生AVF狭窄的发生率为4.6%～10.8%。因此，研究AVF狭窄的机制对于改善HD患者的生存质量及延长血管通路的使用时间至关重要。本文简要介绍了自体AVF的狭窄及分类，重点总结了目前对AVF狭窄机制方面的研究进展(主要包括血管平滑肌细胞增生、血小板聚集和血栓形成、炎症反应、血流剪切力、低氧、免疫系统、基因和遗传及个体化差异等方面)。AVF狭窄的机制是多种因素相互作用的结果，深入了解这些机制有助于开发更加有效的诊断和治疗策略，提高HD患者AVF的通畅率。

关键词: 自体动静脉内瘘, 内瘘狭窄, 血液透析, 慢性肾脏病

Abstract: Autogenous arteriovenous fistula (AVF) is the vascular access most commonly used for hemodialysis (HD) patients. In clinical practice, the prevalence of AVF stenosis is 4.6% to 10.8%. Therefore, exploring the mechanism of AVF stenosis is of vital significance to prolong the blood the access period of AVF and to improve the quality of life in HD patients. This article briefly introduces the autogenous AVF stenosis and its classification, and summarizes the research progresses in the mechanism of AVF stenosis, including vascular smooth muscle cell proliferation, platelet aggregation and thrombus formation, inflammatory reaction, hemodynamic shear force, hypoxia, immune system, genetics and individual differences. The presence of AVF stenosis is the interaction results of multiple factors. A deep understanding of these mechanisms contributes to the development of effective diagnostic and therapeutic strategies to increase the patency rate of AVF in HD patients.

Key words: Autogenous arteriovenous fistula, Internal fistula stenosis, Hemodialysis, Chronic kidney disease

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