|
|
|
| Coagulation Plasma Haemoglobin and D-D Levels in Patients with Diabetic Nnephropathy and The Relationship with Haemodialysis Arteriovenous Fistula Thrombosis |
| LI Li, XUE Lian, WU Menghan |
| West China Hospital of Sichuan University, Sichuan Chengdu 610041, China |
|
|
|
|
Abstract Objective: To analyze the coagulation function, levels of plasma hemoglobin (Hb) and D-dimer (D-D) in patients with diabetic nephropathy (DN) and their relationship with thrombosis of arteriovenous fistula (AVF). Methods: A total of 99 patients with DN confirmed in the hospital were enrolled between February 2020 and February 2022. According to presence or absence of AVF thrombosis, they were divided into thrombosis group (n=34) and simple DN group (n=65). The clinical data in both groups were recorded. The prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB) were detected by freezing method. The level of antithrombase-III (AT-III) and D-D were detected by chromogenic substrates assay. The international normalized ratio (INR) was the ISI power of PT to normal control PT ratio. The level of D-D was detected by immunoturbidimetry. The level of Hb was detected by colorimetry. The predictive value of the above indexes for AVF thrombosis was analyzed by ROC curves. Results: The difference in age, gender, body index (BMI), disease course and blood urea nitrogen between thrombosis group and simple DN group was not statistically significant (P>0.05). The dialysis time and usage time of AVF in simple DN group were significantly shorter than those in thrombosis group (P<0.05), and levels of AT-III, PT, APTT, TT, FIB, INR, Hb and D-D were significantly lower than those in thrombosis group (P<0.05). AUC values of AT-III, PT, APTT, TT, INR, FIB, Hb and D-D for predicting AVF thrombosis were 0.771, 0.788, 0.748, 0.778, 0.673, 0.778, 0.771 and 0.745, respectively. Combined test showed an AUC of 0.963, a sensitivity of 82.35% and a specificity of 81.54%. Conclusion: Coagulation function indexes, Hb and D-D can predict AVF thrombosis in hemodialysis patients.
|
|
|
|
|
|
[1] W Farber E,Hanut A,Tadmor H,et al.Autophagy and diabetic nephropathy[J].Harefuah,2021,160(11):740-745.
[2] Sakr M,Alhwiesh AK,Alharbi A,et al.Iatrogenic hypothermia during hemodialysis can induce serious cardiac arrhythmias in diabetic patient[J].Saudi Kidney Dis Transpl,2021,32(4):1146-1151.
[3] Golper TA.The arteriovenous fistula and progression of kidney disease[J].Kidney,2021,2(1):4-6.
[4] Takahashi EA,Harmsen WS,Misra S.Endovascular arteriovenous dialysis fistula intervention:outcomes and factors contributing to fistula failure[J].Kidney Med,2020,2(3):326-331.
[5] 中华医学会糖尿病分会.2007年版中国2型糖尿病防治指南[J].中华内分泌代谢杂志,2008,24(2):1-22.
[6] 中华医学会糖尿病学分会.中国糖尿病防治指南[M].北京:北京大学出版社,2005.10.
[7] 叶朝阳,戴兵.动静脉内瘘血栓的诊断和处理[J].肾脏病与透析肾移植杂志,2013,22(2):141-142
[8] 单鸿,吴雁翔.肾衰宁胶囊联合替米沙坦对糖尿病肾病患者血管内皮功能及炎症因子水平的影响[J].成都医学院学报,2022,17(1):67-70.
[9] 栗正,王威,包玲,等.肾脏疾病血栓形成期的实验室凝血检查及临床意义[J].山西医药杂志,2019,48(2):155-157.
[10] 刘正亮,张甜甜,李秀勇.血栓通胶囊联合阿司匹林对维持性血液透析动静脉内瘘术后再次血栓形成的疗效及对血清PT、APTT和DD水平影响[J].中华中医药学刊,2021, 39(9):189-192.
[11] Wan Z,Xiang R,Wang H,et al.Comparative efficacy and safety of local and peripheral venous thrombolytic therapy with urokinase for thrombosed hemodialysis arteriovenous fistulas[J].Exp Ther Med,2019,17(5):4279-4284.
[12] 文雪仙,郭宝春,邱晶,等.维持性血液透析患者动静脉内瘘失功的原因分析与护理干预[J].护理实践与研究,2019,16(10):35-37. |
|
|
|
2023, Vol. 29 
