Shafi S T, Gupta M
Division of Nephrology, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
J Vasc Access. 2007 Apr-Jun;8(2):103-8.
Anticardiolipin antibody is associated with increased risk of vascular access thrombosis (VAT) in hemodialysis (HD) patients. Systemic lupus erythematous (SLE) patients have a high prevalence of anticardiolipin antibodies, but it is not clear whether these patients are at high risk of developing vascular access thrombosis.
Thirty six SLE patients on HD, who had either an arterio-venous (AV) graft or AV fistula as vascular access, and were not on anticoagulation treatment, were retrospectively identified at Henry Ford Hospital. A similar number of patients without SLE, matched for age, sex, race and type of vascular access were selected as a control population. Vascular access thrombosis rate at one year was compared between two groups.
Mean age at dialysis was 36+/-10 years in 36 SLE patients (28 females, 8 males) and was 38+/-6.4 years in 36 non-SLE patients (29 females, 7 males). Of all patients, 29/36 (80.5%) SLE and 27/36 (75%) non-SLE patients had AV grafts, whereas the rest had AV fistulas as vascular access (19.5% SLE and 25% non-SLE patients). Out of 36 SLE patients, 24 (66.6%) patients developed VAT at one year as compared to 14 (38.9%) patients in non-SLE group (p<0.05). The odds ratio of VAT in SLE patients was 3.1 (95% CI 1.2-8.2).
SLE patients on hemodialysis are more likely to develop vascular access thrombosis as compared to non-SLE patients.
抗心磷脂抗体与血液透析（HD）患者血管通路血栓形成（VAT）风险增加有关。系统性红斑狼疮（SLE）患者抗心磷脂抗体的患病率较高，但尚不清楚这些患者是否有发生血管通路血栓形成的高风险。
在亨利福特医院对36例接受血液透析的SLE患者进行回顾性研究，这些患者以动静脉（AV）移植物或AV瘘作为血管通路，且未接受抗凝治疗。选择数量相似的无SLE患者作为对照人群，这些患者在年龄、性别、种族和血管通路类型方面相匹配。比较两组患者一年时的血管通路血栓形成率。
36例SLE患者（28例女性，8例男性）透析时的平均年龄为36±10岁，36例非SLE患者（29例女性，7例男性）为38±6.4岁。所有患者中，29/36（80.5%）的SLE患者和27/36（75%）的非SLE患者有AV移植物，其余患者以AV瘘作为血管通路（SLE患者为19.5%，非SLE患者为25%）。36例SLE患者中，24例（66.6%）在一年时发生了VAT，而非SLE组为14例（38.9%）患者（p<0.05）。SLE患者发生VAT的比值比为3.1（95%CI 1.2 - 8.2）。
与非SLE患者相比，接受血液透析的SLE患者更易发生血管通路血栓形成。
