Haznedaroğlu I C, Erdem Y, Celik I, Sayinalp N M, Dündar S V, Cağlar S, Kirazli S
Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.
Blood Purif. 1996;14(3):227-33. doi: 10.1159/000170265.
This study was designed to evaluate local alterations of the fibrinolytic process in patent-functional native arteriovenous fistulas of patients on maintenance haemodialysis. For this aim, the concentrations of the main components of the fibrinolytic system were determined in plasma samples taken simultaneously from arteriovenous fistulas and contralateral upper extremity concurrent large veins of haemodialysis patients. Twelve patients (6 women and 6 men, age 36 +/- 8 years) with end-stage renal disease on maintenance haemodialysis and 15 non-smoker healthy volunteers (8 women and 7 men, age 31 +/- 10 years) with normal renal function were included in the study. The fibrinolytic parameters, except alpha 2-antiplasmin, were found to be elevated in arteriovenous fistulas of haemodialysis patients as compared with opposite upper extremity large veins of the same patients (p < 0.005). Increments in fibrinolytic parameters including tissue plasminogen activator antigen, urokinase-type plasminogen activator antigen and activity, and plasminogen activity together with lower alpha 2-antiplasmin levels favor activation of fibrinolysis, except for higher alpha 2-macroglobulin concentrations, in arteriovenous fistula. The study suggests that the fibrinolytic process is locally activated in arteriovenous fistulas of haemodialysis patients.
本研究旨在评估维持性血液透析患者功能正常的自体动静脉内瘘中纤维蛋白溶解过程的局部改变。为此，在同时从血液透析患者的动静脉内瘘和对侧上肢大静脉采集的血浆样本中，测定纤维蛋白溶解系统主要成分的浓度。本研究纳入了12例维持性血液透析的终末期肾病患者（6例女性和6例男性，年龄36±8岁）以及15名肾功能正常的非吸烟健康志愿者（8例女性和7例男性，年龄31±10岁）。与同一患者对侧上肢大静脉相比，血液透析患者动静脉内瘘中的纤维蛋白溶解参数（除α2 -抗纤溶酶外）均升高（p < 0.005）。在动静脉内瘘中，包括组织纤溶酶原激活物抗原、尿激酶型纤溶酶原激活物抗原和活性以及纤溶酶原活性在内的纤维蛋白溶解参数增加，同时α2 -抗纤溶酶水平降低，这有利于纤维蛋白溶解的激活，除了α2 -巨球蛋白浓度较高。该研究表明，血液透析患者的动静脉内瘘中纤维蛋白溶解过程被局部激活。
