【摘要】 目的 探讨不同血管通路对慢性肾脏病（CKD）5期血液透析患者微炎症指标的影响。方法 回顾性分析2020年1月至2023年1月福建省龙岩市第二医院肾内科100例CKD5血液透析患者资料，根据血管通路不同进行分组，分别为动静脉内瘘（AVF）组（n=50），中心静脉导管（CVC）组（n=50）。收集两组患者血液净化指标[血红蛋白（Hb）、甲状旁腺素（PTH）、β2-微球蛋白（β2-MG）]，炎症指标[超敏C反应蛋白（hs-CRP）、白细胞介素-6(IL-6)、白细胞计数（WBC），透析效果指标[尿素清除指数（Kt/V）、尿素氮（BUN）]以及并发症情况。结果 透析前，两组患者各指标比较差异无统计学意义（P>0.05）；透析6个月后，两组患者PTH、β2-MG水平明显降低，而Hb水平明显升高，但组间比较差异无统计学意义（P>0.05）；透析6个月后，两组患者hs-CRP、IL-6、WBC水平均明显降低，AVF组降低更显著，差异有统计学意义（P<0.05）；透析6个月后，AVF组BUN水平低于CVC组，而Kt/V水平则高于CVC组，差异有统计学意义（P<0.05）;AVF组并发症发生率明显低于CVC组（4.00%vs.12.00%,P<0.05）。结论 相比于CVC,AVF行血液透析可有效改善CKD5期患者微炎症反应，提升透析效果，其安全性更高，临床在条件允许的情况可优先考虑使用AVF作为血管通路。更多还原

【Abstract】 Objective To investigate the effects of different vascular pathways on micro inflammatory markers in patients with chronic kidney disease(CKD) undergoing hemodialysis in stage 5. Method A retrospective analysis was conducted on the data of 100 CKD5 hemodialysis patients in the Nephrology Department of the Second Hospital of Longyan City, Fujian Province from January 2020 to January 2023. The patients were divided into two groups based on different vascular pathways: arteriovenous fistula(AVF) group(n=50) and central venous catheter(CVC)group(n=50). Collect blood purification indicators(Hb, PTH, β 2-MG), inflammatory indicators(hs CRP, IL6, WBC),dialysis efficacy indicators(Kt/V, URR), and complications from two groups of patients. Results Before dialysis,there was no statistically significant difference in various indicators between the two groups of patients(P>0.05); After 6 months of dialysis, the levels of PTH and β 2-MG in both groups of patients decreased significantly, while the level of Hb increased significantly, but there was no statistically significant difference between the groups(P>0.05); After 6 months of dialysis, the levels of hs CRP, IL-6, and WBC in both groups of patients were significantly reduced, with the AVF group showing a more significant decrease, and the difference was statistically significant(P<0.05); After 6months of dialysis, the BUN level in the AVF group was lower than that in the CVC group, while the Kt/V level was higher than that in the CVC group, and the difference was statistically significant(P<0.05); The incidence of complications in the AVF group was significantly lower than that in the CVC group(4.00% vs.12.00%, P<0.05). Conclusion Compared with CVC, AVF undergoing hemodialysis can effectively improve the micro inflammatory response in CKD5 patients, enhance dialysis efficacy, and have higher safety. In clinical practice, AVF can be prioritized as a vascular pathway when conditions permit.更多还原