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终末期肾病(end-stage renal disease,ESRD)血液透析患者心血管疾病发病率较高,因其存在炎症和氧化应激可致内皮功能紊乱,促进心血管疾病的发生。理论上,成功的血液透析过程可以清除蓄积的毒素,逆转炎症和氧化应激,进而减少动脉粥样硬化的发生。然而,透析本身似乎可以加剧炎症,氧化应激和动脉粥样硬化。多种内源性和外源性因子相互作用,诱导内皮损伤和动脉粥样硬化。内源性因子包括肾衰竭患者的炎症和氧化应激成分,而外源性因子来源于透析过程本身。透析器的生物不相容性已成为增加炎症标志物的重要因素。因此,透析过程中的透析膜生物不相容性和透析不充分性可以导致更严重的后果,而不是清除了那些内源性因子。随着透析器的发展,生物相容性膜不仅可以减轻透析相关性炎症,而且可以清除更多的尿毒症毒素和中大分子,这不失为减轻内皮功能紊乱、炎症和氧化应激,并降低ESRD患者发生动脉粥样硬化风险的可行措施。
End-stage renal disease (ESRD) hemodialysis patients with a higher incidence of cardiovascular disease, because of their presence of inflammation and oxidative stress can cause endothelial dysfunction, and promote the occurrence of cardiovascular disease. In theory, a successful hemodialysis process removes accumulated toxins, reverses inflammation and oxidative stress, thereby reducing atherosclerosis. However, dialysis itself seems to exacerbate inflammation, oxidative stress and atherosclerosis. Multiple endogenous and extrinsic factors interact to induce endothelial damage and atherosclerosis. Endogenous factors include inflammation and oxidative stress in patients with renal failure, whereas exogenous factors are derived from the dialysis process itself. The biological incompatibility of dialyzers has become an important factor in increasing the markers of inflammation. Therefore, dialysis membrane dialysis incompatibility and inadequate dialysis can lead to more serious consequences, rather than remove those endogenous factors. With the development of dialyzers, biocompatible membranes not only reduce dialysis-related inflammation, but also remove more uremic toxins and macromolecules, which may reduce endothelial dysfunction, inflammation and oxidative stress and reduce ESRD Feasible risk of developing atherosclerosis in patients.