自体动静脉内瘘内膜增生的研究进展

血管通路是血液透析患者的生命线,而自体动静脉内瘘(AVF)建立后发生血管重构,其中一部分患者的AVF在血管重构过程中可发生狭窄以致血管通路功能不良,使得透析不充分或失败。AVF狭窄机制中内膜增生是其主要的组织病理学因素,而炎症、尿毒症、低氧状态、剪切应力、血栓是内膜增生的生物学机制。本文综述了内膜增生的细胞来源,因血流动力学变化而产生的不同模式剪切应力中炎症反应、炎症介质表达和氧化应激等对内膜增生的影响,有望提出针对内膜增生的靶点治疗模式。

Research progress of intimal hyperplasia in autogenous arteriovenous fistula

Vascular access is the lifeblood of hemodialysis patients. Vascular remodeling develops after establishment of autogenous arteriovenous fistula (AVF), but some patients may have AVF stenosis in the vascular remodeling process, which then leads to access dysfunction and thus inadequate dialysis or failure in dialysis. Studies on the mechanism indicate that intimal hyperplasia is one of main pathological factors for AVF stenosis, while inflammation, uremia, hypoxia, shear stress and thrombus are the biological mechanism for intimal hyperplasia. In this paper, we reviewed the cell sources of intimal hyperplasia and the effects of inflammatory responses, inflammatory mediators and oxidative stress under different shear stresses produced by hemodynamic changes on intimal hyperplasia, and expected to bring forward new targets for the treatment of intimal hyperplasia.