血小板活化因子对慢性肾衰竭血液透析患者导管功能异常有预测作用

杨娜.血小板活化因子对慢性肾衰竭血液透析患者导管功能异常有预测作用[J].内科急危重症杂志,2025,31(4):338-342

DOI：10.11768/nkjwzzzz20250410

英文关键词:

基金项目:陕西省卫生健康科研基金项目（2021A003）

作者	单位	E-mail
杨娜	陕西省咸阳市中心医院	15191801507@163.com

摘要点击次数: 10

全文下载次数: 13

中文摘要:

摘要目的：探讨血小板活化因子（PAF）对慢性肾衰竭血液透析患者导管功能异常的预测作用。方法：选择108例慢性肾衰竭血液透析患者作为研究对象，分为导管功能异常(置管3个月内连续3次血流量<200 mL/min)组38例和导管功能良好组70例，比较2组患者的基线资料和生化指标。采用广义混合效应模型分析血PAF水平与慢性肾衰竭血液透析患者导管功能异常的关系，并进行亚组分析。采用限制性立方样条模型分析血PAF水平与导管功能异常的剂量反应关系。结果：本研究中导管功能异常率为35.19%，2组封管方法、透析前中心静脉压（CVP）比较，差异有统计学意义（P均<0.05）。与导管功能良好组比较，导管功能异常组患者血超敏C 反应蛋白（hsCRP）和PAF水平更高，白蛋白（Alb）水平和活化部分凝血活酶时间（APTT）更低（P均<0.05）。广义混合效应模型结果显示，血PAF水平与患者导管功能异常有关，且亚组间不存在交互作用（P互＞0.05）。PAF水平与患者导管功能异常呈线性剂量反应关系（P=0.439）。结论：血PAF水平是慢性肾衰竭血液透析患者导管功能异常的影响因素，对患者导管功能异常具有一定预测价值。

英文摘要:

Abstract Objective: To explore the predictive role of platelet-activating factor (PAF) in catheter dysfunction in patients with chronic renal failure undergoing hemodialysis. Methods: A total of 108 patients with chronic renal failure undergoing hemodialysis were selected as the research subjects. They were divided into the group with abnormal catheter function (having a continuous blood flow of less than 200 mL/min for 3 consecutive times within 3 months after catheter placement) with 38 cases and the group with normal catheter function with 70 cases. The baseline data and biochemical indicators of the two groups were compared. The generalized mixed-effects model was used to analyze the relationship between PAF levels and abnormal catheter function in patients with chronic renal failure undergoing hemodialysis, and subgroup analysis was conducted. The restricted cubic spline model was used to analyze the dose-response relationship between PAF and abnormal catheter function. Results: In this study, the rate of abnormal catheter function was 35.19%. There were statistically significant differences in the catheter sealing methods and central venous pressure (CVP) before dialysis between the two groups (all P< 0.05). Patients in the group with abnormal catheter function had higher levels of high-sensitivity C-reactive protein (hsCRP) and PAF, and lower levels of albumin (Alb) and activated partial thromboplastin time (APTT) than in the group with normal catheter function (all P< 0.05). The results of the generalized mixed-effects model indicated that the PAF level was associated with the dysfunction of the patient's catheter, and there was no interaction among the subgroups (P interaction > 0.05). The PAF level showed a linear dose-response relationship with the abnormality of the patient's catheter function (P = 0.439). Conclusion: PAF is an influencing factor for catheter dysfunction in patients with chronic renal failure undergoing hemodialysis, and it has certain predictive value for catheter dysfunction in these patients.