CAJ | 학술논문

目的：探讨阿托伐他汀联合远红外线照射对维持性血液透析患者自体动静脉内瘘血栓形成的临床疗效。方法选取2014年1～12月贵州省人民医院血液透析中心使用自体内瘘的维持性血液透析患者92例，随机分为干预组（予以阿托伐他汀联合远红外线照射治疗，46例）和对照组（以性别、年龄成组匹配，未予以阿托伐他汀治疗的患者，46例）。多普勒彩色超声检查内瘘有无狭窄或栓塞，测定每分钟血流量。收集年龄、性别、BMI、肾病病程、透析病程、原发病因、并发症；纤维蛋白原、D-二聚体、超敏C-反应蛋白（hs-CRP）、血红蛋白、血脂、透析充分性（Kt/V）等临床指标。随访1年，以发生内瘘血栓为终点事件，比较两组患者内瘘血流量变化及内瘘并发症的发生率。结果经随访1年后，干预组患者Kt/v值较对照组患者增加，hs-CRP、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、D-二聚体等指标较对照组患者减低（P＜0.05）。与对照组相比，干预组血流量增值明显高于对照组（P＜0.05）；随访结束后，1例干预组患者、3例对照组患者发生 AVF功能障碍。结论阿托伐他汀联合远红外治疗通过减缓体内炎症因子及血栓形成因素水平达到保护自体动静脉内瘘的作用，值得临床推广使用。
목적：탐토아탁벌타정연합원홍외선조사대유지성혈액투석환자자체동정맥내루혈전형성적림상료효。방법선취2014년1～12월귀주성인민의원혈액투석중심사용자체내루적유지성혈액투석환자92례，수궤분위간예조（여이아탁벌타정연합원홍외선조사치료，46례）화대조조（이성별、년령성조필배，미여이아탁벌타정치료적환자，46례）。다보륵채색초성검사내루유무협착혹전새，측정매분종혈류량。수집년령、성별、BMI、신병병정、투석병정、원발병인、병발증；섬유단백원、D-이취체、초민C-반응단백（hs-CRP）、혈홍단백、혈지、투석충분성（Kt/V）등림상지표。수방1년，이발생내루혈전위종점사건，비교량조환자내루혈류량변화급내루병발증적발생솔。결과경수방1년후，간예조환자Kt/v치교대조조환자증가，hs-CRP、총담고순、저밀도지단백담고순（LDL-C）、D-이취체등지표교대조조환자감저（P＜0.05）。여대조조상비，간예조혈류량증치명현고우대조조（P＜0.05）；수방결속후，1례간예조환자、3례대조조환자발생 AVF공능장애。결론아탁벌타정연합원홍외치료통과감완체내염증인자급혈전형성인소수평체도보호자체동정맥내루적작용，치득림상추엄사용。
ObjectiveTo investigate the clinical effect of atorvastatin combined with far-infrared radiation on autogenous arteriovenous fistula in patients with chronic kidney disease undergoing maintenance hemodialysis.Methods 92 patients used autogenous arteriovenous fistula more than one year from January, 2014 to December, 2014 in Guizhou Provincial People's Hospital hemodialysis centers were randomly divided into combination therapy group (46 cases) and control group (46 cases). Patients in combination therapy group treated with atorvastatin combined with far-infrared radiation, control group, matched with age and gender, were not treated with atorvastatin. Blood flow changes and the incidence of fistula dysfunction were detected by Doppler ultrasound. Demographic characteristics, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, D-dimer, hemoglobin, lipids, and hemodialysis adequacy (Kt/v) were collected. After 1-year follow-up, the incidence of fistula thrombosis and blood flow changes were compared in two groups.ResultsCompared with the control group, hemodialysis adequacy (Kt/V) in study group was significantly higher after combination therapy for 1 year (P<0.05), while hs-CRP, total cholesterol, LDL-C and D-dimer decreased. Blood flow value in combination therapy group were higher than control group (P<0.05). At the end of follow-up, 1 case in combination therapy group and 3 cases in control group experienced AVF dysfunction (97.36%vs.93.02%).ConclusionAtorvastatin with far-infrared radiation therapy might protect AVF via reducing inflammatory factors and thrombosis factors and deserve to be widely used in clinic.