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How to carry out monthly blood flow surveillance of fistula in large-scale hemodialysis units: A cross-sectional study.
如何开展大型血液透析单位内瘘的每月血流监测: 一项横断面研究。
- 影响因子:1.12
- DOI:10.1177/1129729820923939
- 作者列表:"Mo YW","Sun CY","Song L","Zhou LF","Zhuang TT","Zhong M","Zheng SQ","Chen YG","Chen YH","Liu SX","Liang XL","Fu X
- 发表时间:2021-01-01
Abstract
BACKGROUND:The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex Doppler ultrasound during the nondialysis period. However, the surveillance workload for arteriovenous fistula has increased with the rapid increase in the hemodialysis population size. Efficient methods for blood flow surveillance during hemodialysis are needed. METHODS:Eighty-four hemodialysis patients with a forearm radiocephalic arteriovenous fistula were enrolled in this cross-sectional study. Each received blood flow measurements using ultrasonic dilution technique and duplex Doppler ultrasound during hemodialysis. Duplex Doppler ultrasound measurements included the blood flow of the brachial artery and radial artery. The correlations between these variables were analyzed. RESULTS:The correlation coefficients (r) between flow measured by ultrasonic dilution technique and brachial artery flow measured by duplex Doppler ultrasound, between flow measured by ultrasonic dilution technique and radial artery flow measured by duplex Doppler ultrasound, and between brachial artery flow and radial artery flow measured by duplex Doppler ultrasound were 0.724, 0.784, and 0.749, respectively (all p < 0.001). CONCLUSION:Blood flow measured by ultrasonic dilution technique was positively correlated with blood flow measured by duplex Doppler ultrasound during hemodialysis, suggesting that duplex Doppler ultrasound can be used to monitor the trends in the blood flow of the brachial artery and radial artery for timely intervention to improve patency during hemodialysis.
摘要
背景: 定期血流监测对动静脉内瘘的维护具有重要作用。超声稀释技术用于血流监测可以在血液透析期间进行,但存在一些局限性。在非透析期间,传统上通过双重多普勒超声测量血流。然而,动静脉内瘘的监测工作量随着血液透析人群规模的快速增加而增加。需要在血液透析期间进行血流监测的有效方法。 方法: 84例有前臂放射性动静脉内瘘的血液透析患者纳入本横断面研究。在血液透析期间使用超声稀释技术和双重多普勒超声每个接收的血流测量。多普勒超声测量包括肱动脉和桡动脉的血流。分析这些变量之间的相关性。 结果: 超声稀释技术测得的血流与双功多普勒超声测得的肱动脉血流、超声稀释技术测得的血流与双功多普勒超声测得的桡动脉血流、双功多普勒超声测得的肱动脉血流与桡动脉血流的相关系数 (r) 分别为0.724,0.784,和0.749 (均p <0.001)。 结论: 超声稀释技术测得的血流量与血液透析中双重多普勒超声测得的血流量呈正相关,提示双重多普勒超声可用于监测肱动脉和桡动脉血流的变化趋势,以便及时干预,提高血液透析的通畅性。
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METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
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