中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (03): 226-230.doi: 10.3969/j.issn.1671-4091.2025.03.012

• 综述 • 上一篇    下一篇

间充质干细胞在抑制尿毒症患者动静脉内瘘血管内膜细胞增生的研究进展

罗 彤   鄢 艳   

  1. 330006 南昌，1南昌大学第一附属医院肾内科
  • 收稿日期:2024-09-19 修回日期:2024-12-16 出版日期:2025-03-12 发布日期:2025-03-12
  • 通讯作者: 鄢艳 E-mail:kiddoc@163.com
  • 基金资助:
    国家自然科学基金(82060148)

Research progress in the use of mesenchymal stem cells to inhibit intimal hyperplasia in arteriovenous fistula in uremic patients

LUO Tong, YAN Yan   

  1. Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
  • Received:2024-09-19 Revised:2024-12-16 Online:2025-03-12 Published:2025-03-12
  • Contact: 330006 南昌，1南昌大学第一附属医院肾内科 E-mail:kiddoc@163.com
  • Supported by:

摘要：

慢性肾脏病(chronic kidney disease，CKD)发病率逐年升高，持续进展的最终结局为终末期肾病(end-stage renal disease，ESRD)。维持性血液透析(maintenance hemodialysis, MHD)是ESRD患者的主要替代治疗方式之一，动静脉内瘘(arteriovenous fistula，AVF)是MHD患者血管通路的首选类型。然而，AVF功能障碍缩短了AVF使用时长，是血液透析患者常见的并发症之一。新生内膜增生(neointimal hyperplasia，NIH)导致的AVF狭窄是MHD患者AVF患病率增加的主要原因。全身药物治疗或局部治疗均可抑制AVF内膜增生，间充质干细胞因其多元分化、自我更新、组织修复、归巢、旁分泌等特性在血管内膜增生领域具有极大的潜能。本文主要通过对ESRD患者AVF内膜增生的机制及治疗进展、间充质干细胞的研究进展、改善血管内膜增生的作用机制等方面进行综述，寻找预防血管通路障碍发生的新思路。

关键词: 间充质干细胞, 尿毒症, 维持性血液透析, 动静脉内瘘, 内膜增生

Abstract:

The incidence of chronic kidney disease (CKD) is increasing year by year. Continuous progress of CKD may finally lead to end-stage renal disease (ESRD). Maintenance hemodialysis (MHD) is one of the alternative treatments for ESRD patients, and arteriovenous fistula (AVF) is the preferred type of blood access for MHD. However, AVF dysfunction occurs frequently, leading to a short lifetime of blood access. Narrowing of AVF by neointimal hyperplasia is the main cause of AVF dysfunction. Previous studies have shown that both systemic and local treatments may inhibit the intimal hyperplasia. Mesenchymal stem cells have the potentials of diverse differentiation, self-renewal, tissue repair, homing and paracrine activities, probably useful for the reversal of neointimal hyperplasia in AVF. This article reviews recent advances in the mechanism and treatment of AVF dysfunction, the use of mesenchymal stem cells, and the mechanisms underlying the reversal of neointimal hyperplasia, in order to find out new ideas for the prevention of AVF dysfunction.

Key words: Mesenchymal stem cell, Uremia, Maintenance hemodialysis, Arteriovenous fistula, Intimal hyperplasia

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