慢性肾脏病患者造瘘术前凝血–纤溶系统功能及其对内瘘通畅性的预测价值研究
Study on the Preoperative Coagulation-Fibrinolysis Function in Patients with Chronic Kidney Disease before Fistula Creation and Its Predictive Value for Fistula Patency
DOI: 10.12677/acm.2026.162426, PDF,   
作者: 王孟格, 米永华*：重庆医科大学附属永川医院检验科，重庆
关键词: 慢性肾脏病；动静脉内瘘；凝血；纤溶；Chronic Kidney Disease； Arteriovenous Fistula； Coagulation； Fibrinolysis
摘要: 慢性肾脏病患者造瘘术前常伴有凝血–纤溶系统功能紊乱，这可能导致术后动静脉内瘘功能障碍。本文系统分析了尿毒症毒素、炎症反应和内皮间质转化等病理生理机制对凝血–纤溶平衡的影响，并评估了常规凝血指标、血栓弹力图及特异性分子标志物在预测内瘘功能方面的应用潜力。此外，多组学技术与人工智能预测模型的引入显著提升了风险评估的准确性，为个体化抗凝治疗策略的制定提供了新思路。结论表明，术前全面评估凝血–纤溶功能对改善内瘘长期通畅性具有重要的临床意义。
Abstract: Patients with chronic kidney disease often present with coagulation-fibrinolysis system dysfunction before fistula creation, which may contribute to postoperative arteriovenous fistula (AVF) dysfunction. This review systematically analyzes the impact of pathophysiological mechanisms—such as uremic toxins, inflammatory responses, and endothelial-mesenchymal transition—on the coagulation-fibrinolysis balance. It also evaluates the potential of conventional coagulation parameters, thromboelastography, and specific molecular biomarkers in predicting AVF outcomes. Furthermore, the integration of multi-omics technologies and artificial intelligence-based predictive models has significantly improved the accuracy of risk assessment, offering novel insights for developing individualized anticoagulation strategies. In conclusion, a comprehensive preoperative evaluation of coagulation-fibrinolysis function holds substantial clinical significance for enhancing the long-term patency of AVFs.
文章引用：王孟格, 米永华. 慢性肾脏病患者造瘘术前凝血–纤溶系统功能及其对内瘘通畅性的预测价值研究[J]. 临床医学进展, 2026, 16(2): 576-585. https://doi.org/10.12677/acm.2026.162426

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