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首页> 外文期刊>Vascular and endovascular surgery >Cilostazol May Improve Maturation Rates and Durability of Vascular Access for Hemodialysis
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Cilostazol May Improve Maturation Rates and Durability of Vascular Access for Hemodialysis

机译：西洛替唑可以提高血液透析血管血清血管进入的成熟率和耐久性

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Cilostazol is effective in controlling pathophysiological pathways similar or identical to those involved in nonmaturation and failure of the arteriovenous access. This case-control study examined whether cilostazol would improve maturation rates and durability of vascular access for hemodialysis. The treatment group included 33 patients who received cilostazol for >= 30 days prior to creation of a dialysis access and continued with cilostazol therapy for >= 60 days after surgery. The matched (gender, age, race, diabetes, and the year of surgery) control group included 116 patients who underwent the same procedure but did not receive cilostazol prior to and at least 3 months after surgery. Primary outcomes were maturation and, for those that matured, time of functioning access, defined as the time from the first use to irreparable failure of the access. Secondary outcomes were time to maturation, complications, and time to first complication. Study group patients were 3.8 times more likely to experience fistula maturation compared to the controls (88% vs 66%, RR = 3.8, 95% confidence interval: 1.3-11.6, P =.016). Fewer patients in the study group had complications (76% vs 92%, P =.025), and the time from construction of the fistula to the first complication was longer (345.6 +/- 441 days vs 198.3 +/- 185.0 days, P =.025). Time to maturation was similar in both groups (119.3 +/- 62.9 days vs 100.2 +/- 61.7 days, P =.2). However, once matured, time to failure was significantly longer in the treatment group (903.7 +/- 543.6 vs 381.6 +/- 317.2 days, P =.001). Multivariate analysis confirmed that the likelihood of maturation was significantly higher in the treatment group patients. These results suggest that dialysis access patients may benefit from preoperative and postoperative cilostazol therapy. If confirmed by a randomized trial, this treatment will have a major beneficial impact on patients dependent on a well-functioning access for their hemodialysis.
机译：西洛司唑可有效地控制与参与的那些参与动静脉通道的非饱和度和失败的病理生理途径。这种情况对照研究检查了西洛替唑是否会提高血液透析血管血液血液透析的成熟率和耐久性。治疗组包括33名患者在创建透析前之前接受西洛替唑> = 30天，并在手术后持续存在于Cil​​ostazol治疗。匹配的（性别，年龄，种族，糖尿病和手术年份）对照组包括116名患者，患者接受同样的程序，但在手术后至少3个月内没有接受西洛替唑醇。主要结果是成熟，并且对于那些成熟的时间，运作的时间的时间，定义为从第一次用来无法弥补的访问失败的时间。二次结果是时间成熟，并发症和第一次复杂化的时间。研究组患者体验瘘管成熟的可能性比对照组的可能性更高3.8倍（88％vs 66％，RR = 3.8，95％置信区间：1.3-11.6，P = .016）。研究组的患者较少的患者具有并发症（76％vs 92％，p = .025），并且从瘘管构建到第一个并发症的时间更长（345.6 +/- 441天与198.3 +/- 185.0天， p = .025）。两组成熟的时间相似（119.3 +/- 62.9天与100.2 +/- 61.7天，p = .2）。然而，一旦成熟，治疗组失败的时间明显更长（903.7 +/- 543.6 Vs 381.6 +/- 317.2天，P = .001）。多变量分析证实，治疗组患者的成熟可能性显着高。这些结果表明，透析访问患者可能会受益于术前和术后西洛他唑治疗。如果通过随机试验确认，这种治疗将对依赖于血液透析的功能良好的患者具有重大有益影响。

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