中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (01): 73-77.doi: 10.3969/j.issn.1671-4091.2026.01.017

• 血管通路 • 上一篇    下一篇

血清可溶性凝集素样氧化低密度脂蛋白受体-1、补体C1q/肿瘤坏死因子相关蛋白9水平与动静脉内瘘血栓形成的关系

刘翠银   芮凡丁   黄扬扬   毕春生   

  1. 243000 马鞍山，1德驭医疗马鞍山总医院肾内科
  • 收稿日期:2025-04-10 修回日期:2025-10-13 出版日期:2026-01-12 发布日期:2025-12-31
  • 通讯作者: 芮凡丁 E-mail:270274804@qq.com

The relationship between serum soluble lectin-like oxidized low density lipoprotein receptor-1 and complement C1q/TNF-related protein 9 levels and arteriovenous fistula thrombosis in maintenance hemodialysis patients

LIU Cui-yin, RUI Fan-ding, HUANG Yang-yang, BI Chun-sheng   

  1. Department of Nephrology, Ma'anshan General Hospital of Ranger-Duree Healthcare,  Ma'anshan 243000, China
  • Received:2025-04-10 Revised:2025-10-13 Online:2026-01-12 Published:2025-12-31
  • Contact: 243000 马鞍山，1德驭医疗马鞍山总医院肾内科 E-mail:270274804@qq.com

摘要： 目的  探究血清可溶性凝集素样氧化低密度脂蛋白受体-1(soluble lectin-like oxidized low density lipoprotein receptor-1，sLOX-1)、补体C1q/肿瘤坏死因子相关蛋白9(C1q/TNF-related protein 9，CTRP9)水平与维持性血液透析患者动静脉内瘘血栓形成的关系。 方法  选取2022年11月—2024年3月在德驭医疗马鞍山总医院进行血液透析并发动静脉内瘘血栓形成的患者为观察组，另选取同期行血液透析未并发动静脉内瘘血栓形成的患者为对照组，所有患者入组时均已接受≥3年的维持性血液透析治疗。酶联免疫吸附法(enzyme-linked immunosorbnent assay，ELISA)检测血清sLOX-1、CTRP9水平。Pearson法分析动静脉内瘘血栓形成与患者血清sLOX-1、CTRP9水平的相关性。Logistic回归分析血栓形成的因素。采用受试者工作特征曲线(receiver operating characteristic curve，ROC)分析血清sLOX-1、CTRP9水平预测动静脉内瘘血栓形成的效能。 结果  共纳入244例患者，其中观察组124例，对照组120例。2组间平均动脉压(t=5.964，P＜0.001)、低密度脂蛋白胆固醇(t=20.356，P＜0.001)比较差异有统计学意义。观察组血清CTRP9水平(t=9.703，P＜0.001)较对照组低，血清sLOX-1水平(t=9.747，P＜0.001)较对照组高。观察组血清CTRP9与血清sLOX-1水平呈负相关(r=-0.422，P＜0.001)。高水平的血清sLOX-1(OR=2.371，95% CI：1.386～4.057，P=0.002)是患者发生动静脉内瘘血栓形成的独立危险因素，高水平的血清CTRP9(OR=0.746，95% CI：0.570～0.976，P=0.032)是患者发生动静脉内瘘血栓形成的独立保护因素。血清sLOX-1、CTRP9水平及二者联合预测患者发生动静脉内瘘血栓形成的AUC分别为0.832、0.807、0.894，联合预测患者发生动静脉内瘘血栓形成优于单独预测(ZsLOX-1-二者联合=2.021、ZCTRP9-二者联合=2.458，PsLOX-1-二者联合=0.043、PCTRP9-二者联合=0.014)。 结论  通过检测维持性血液透析患者血清sLOX-1、CTRP9水平可对患者发生动静脉内瘘血栓形成事件的风险进行评估，为临床早期干预及治疗动静脉内瘘血栓形成提供参考价值。

关键词: 可溶性凝集素样氧化低密度脂蛋白受体-1, 补体C1q/肿瘤坏死因子相关蛋白9, 维持性血液透析, 动静脉内瘘血栓

Abstract: Objective  To investigate the relationship between serum soluble lectin-like oxidized low density lipoprotein receptor-1(sLOX-1) and complement C1q/tumor necrosis factor related protein 9 (CTRP9) levels and arteriovenous fistula (AVF) thrombosis in maintenance hemodialysis (MHD) patients.  Methods  From November 2022 to March 2024, a total of 124 patients who underwent hemodialysis in our hospital and developed thrombosis in AVF were recruited as the observation group. Moreover, a total of 120 patients who underwent hemodialysis in our hospital but did not develop AVF thrombosis were recruited as the control group. These patients had received MHD for more than 3 years at the time of investigation. Serum sLOX-1 and CTRP9 levels were determined by ELISA. Pearson correlation analysis was used for the correlation between serum sLOX-1 and CTRP9 levels and AVF thrombosis, logistic regression for the influencing factors for AVF thrombosis, and ROC curve for the efficacy of serum sLOX-1 and CTRP9 levels in predicting the occurrence of AVF thrombosis.  Results There were statistically significant differences between the observation group and the control group in mean arterial pressure (t=5.964, P＜0.001) and low-density lipoprotein cholesterol levels (t=20.356, P＜0.001). In the observation group, serum CTRP9 was lower (t=9.703, P＜0.001) and serum sLOX-1 was higher (t=9.747, P＜0.001) as compared those in the control group; serum CTRP9 level was negatively correlated with serum sLOX-1 level (r=-0.422, P＜0.001). Higher serum sLOX-1 level (OR=2.371, 95% CI: 1.386～4.057, P=0.002) was the independent risk factor for AVF thrombosis in patients, whereas higher serum CTRP9 level (OR=0.746, 95% CI: 0.570～0.976, P=0.032) was the independent protective factor against AVF thrombosis. The AUCs using serum sLOX-1, CTRP9 and combination of sLOX-1 and CTRP9 levels to predict the occurrence of AVF thrombosis were 0.832, 0.807 and 0.894 respectively, demonstrating that combination of the two levels is better than serum sLOX-1 or serum  CTRP9 for the prediction (sLOX-1–the combination: Z=2.021, P=0.043; CTRP9–the combination: Z=2.458, P=0.014).  Conclusion  Determination of serum sLOX-1 and CTRP9 levels can assess the risk of AVF thrombosis in MHD patients, and can also provide reference values for early intervention of AVF thrombosis in clinical practice.

Key words: Soluble lectin-like oxidized low density lipoprotein receptor-1, Complement C1q/tumor necrosis factor related protein 9, Maintenance hemodialysis, Arteriovenous fistula thrombosis

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