维持性血液透析患者中MIA综合征的临床分析

The clinical manifestation of the MIA syndrome on continuous hemodialysis patients

目的探讨血液透析患者MIA综合征的发生率、临床表现及与透析的充分性之间的相关性。方法对142例血透患者进行了营养指标、慢性炎症状况、心血管疾病的横断面调查。结果142例维持性血透患者普遍存在着营养不良,其发生率为轻中度42.3%(60/142),重度7.0%(10/142),总发生率为49.3%(70/142)。142例血CRP为0.33～44(5.55±10.22)mg/L,慢性炎症35例(24.6%)超过正常值(8mg/L)。142例有心血管疾病表现的总发生率为52.1%(74/142)。提示维持性血透患者存在营养不良、炎症、心血管疾病是较常见的。而兼有营养不良、炎症、心血管疾病即MIA综合征者为19.0%(27/142),但MIA综合征的发生与透析充分性无明显关系。结论血液透析患者中存在MIA综合征,且营养不良、心血管疾病及炎症之间可能是相互关联的。

Objective To analyze the relationship between morbidity, clinical manifestation and adequacy of hemodialysis in hemodialysis patients with MIA syndrome. Methods We made a cross-section survey on the nutritional condition, chronic inflammatory state ,cardiovascular diseases in 142 hemodialysis patients. Results There were widespread malnutrition in the 142 continuous hemodialysis patients. The rates were ： mild-moderate malnutrition 42.3% （60/142）, severe malnutrition 7.0% （10/142）, total 49.3%（70/142）. Their CRP values were between 0.33±44 （5.55±10.22）mg/L,of which 35 cases（24.6%） were beyond the normal value （8mg/L）,indicating a chronic inflammatory state. 52.1% （74/142） of the 142 patients had cardiovascular diseases manifestation. The results indicated that malnutrition,inflammation and cardiovascular diseases were commonly seen on continuous hemodialysis patients ,and the rate of those who had all above situations（ie. MIA syndrome）was 19.0% （27/142）. However,there was not an obvious relationship between MIA syndrome and adequacy of hemodialysis. Conclusions MIA syndrome happens to hemodialysis patients, and there can possibly be some relationship between malnutrition ,inflammation and cardiovascular diseases.