中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (03): 246-250.doi: 10.3969/j.issn.1671-4091.2026.03.015

• 血管通路 • 上一篇    下一篇

血清残粒脂蛋白胆固醇、核因子-κB、基质相互作用分子1与维持性血液透析患者动静脉内瘘血栓形成的关系

李 秀    李红兵    吴爱纯    张小曼    闵永龙   

  1. 430030 武汉，武汉市第一医院 1血液净化中心 2肾病内科
  • 收稿日期:2025-05-22 修回日期:2026-01-07 出版日期:2026-03-12 发布日期:2026-03-12
  • 通讯作者: 李秀 E-mail:j33zl5@163.com
  • 基金资助:
    武汉市科研项目(WZ24B58)

The relationship between serum levels of RLP-C, NF-κB and STIM1 and arteriovenous fistula thrombosis in maintenance hemodialysis patients

LI Xiu, LI Hong-bing, WU Ai-chun, ZHANG Xiao-man, MIN Yong-long   

  1. Blood Purification Center, and 2Department of Nephrology, Wuhan First Hospital, Wuhan 430030, China
  • Received:2025-05-22 Revised:2026-01-07 Online:2026-03-12 Published:2026-03-12
  • Contact: 闵永龙 E-mail:j33zl5@163.com

摘要： 目的  探究血清残粒脂蛋白胆固醇(residual lipoprotein-cholesterol，RLP-C)、核因子κB(nuclear factor kappa B，NF-κB)、基质相互作用分子1(stromal interaction molecule 1, STIM1)与维持性血液透析(maintenance hemodialysis，MHD)患者动静脉内瘘血栓形成的关系。 方法  选取武汉市第一医院行自体动静脉内瘘成形术的209例MHD患者(研究组)，手术后随访12个月，71例发生血栓形成，138例未发生。另设同期健康体检者243例(对照组)。测定血清RLP-C、NF-κB、STIM1水平。 结果  研究组血清RLP-C、NF-κB、STIM1、C反应蛋白(C-reactive protein，CRP)、白细胞介素-6(interleukin-6，IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)水平均高于对照组(t=35.664、54.133、34.955、59.703、97.831、32.253，均P＜0.001)。血栓形成组上述各项指标及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol，LDL-C)水平均高于无血栓形成组(t=7.848、8.662、7.761、9.161、12.541、6.076、59.703，均P＜0.001)。Logistic回归分析显示LDL-C(OR=4.725、95%CI：2.640～8.457，P＜0.001)、IL-6(OR=3.782、95%CI：1.491～9.595，P=0.005)、CRP(OR=5.019、   95%CI：1.083～3.766，P=0.027)、TNF-α(OR=4.396、95%CI：2.741～7.050，P＜0.001)、RLP-C(OR=5.627、95%CI：3.586～5.970，P＜0.001)、NF-κB(OR=6.250、95%CI：4.281～9.124，P＜0.001)、STIM1(OR=6.468、95%CI：3.356～8.908，P＜0.001)为血栓形成的危险因素。血清RLP-C、NF-κB、STIM1与IL-6(r=0.533、0.614、0.504，均P＜0.001)、CRP(r=0.714、0.568、0.672，均P＜0.001)、TNF-α(r=0.635、0.527、0.493，均P＜0.001)呈正相关。三者联合预测血栓形成的曲线下面积优于RLP-C(Z=2.630，P=0.009)、NF-κB(Z=2.539，P=0.011)、STIM1(Z=3.013，P=0.003)单独预测。 结论  MHD患者血清RLP-C、NF-κB、STIM1与微炎症状态及血栓形成有关，联合检测或可预测血栓风险。

关键词: 动静脉内瘘, 血栓形成, 残粒脂蛋白胆固醇, 核因子κB, 基质相互作用分子1

Abstract: Objective  To investigate the relationship between serum levels of residual lipoprotein cholesterol (RLP-C), nuclear factor kappa B (NF-κB), and stromal interaction molecule 1 (STIM1) and arteriovenous fistula (AVF) thrombosis in maintenance hemodialysis (MHD) patients.  Methods  A total of 209 MHD patients undergoing autologous AVF surgery at our Hospital was selected. During the 12-month follow-up study, 71 patients developed thrombosis and 138 did not. In addition, 243 healthy individuals were recruited  as the control group. Serum samples were collected to measure serum levels of RLP-C, NF-κB, and STIM1.  Results  Serum levels of RLP-C, NF-κB, STIM1, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were higher in the MHD patients than in the control group (t=35.664, 54.133, 34.955, 59.703, 97.831 and 32.253 respectively; all P＜0.001). The thrombosis group exhibited higher levels of all aforementioned indicators and low-density lipoprotein cholesterol (LDL-C) compared to the non-thrombosis group (t=7.848, 8.662, 7.761, 9.161, 12.541, 6.076 and 59.703 respectively; all P＜0.001). LDL-C (OR=4.725, 95% CI: 2.640～8.457, P＜0.001), IL-6 (OR=3.782, 95% CI: 1.491～9.595, P=0.005), and CRP (OR=5.019, 95% CI: 1.083～3.766, P=0.027), TNF-α (OR=4.396, 95% CI: 2.741～7.050, P＜0.001), RLP-C (OR=5.627, 95% CI: 3.586～5.970, P＜0.001), NF-κB (OR=6.250, 95% CI: 4.281～9.124, P＜0.001), and STIM1 (OR=6.468, 95% CI: 3.356～8.908, P＜0.001) were identified as the risk factors for AVF thrombosis. Serum RLP-C, NF-κB, and STIM1 were positively correlated with IL-6 (r=0.533, 0.614 and 0.504; P＜0.001), CRP (r=0.714, 0.568 and 0.672; P＜0.001) and TNF-α (r=0.635, 0.527 and 0.493; P＜0.001). The area under the curve of combined use of RLP-C, NF-κB and  STIM1 was superior to that of individual use of RLP-C (Z=2.630, P=0.009), NF-κB (Z=2.539, P=0.011), and STIM1 (Z=3.013, P=0.003) for the prediction of AVF thrombosis.  Conclusion Serum RLP-C, NF-κB and STIM1 in MHD patients correlate with micro-inflammatory state and AVF thrombosis. Combined use of serum RLP-C, NF-κB and STIM1 may predict the risk  of AVF thrombosis in MD patients.

Key words: Arteriovenous fistula, Thrombosis, Residual lipoprotein-cholesterol, Nuclear factor kappa B, Stromal interaction molecule 1

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