维持性血液透析患者营养不良、炎症和心血管疾病的关系

Relationship between malnutrition,inflammation and cardiovascular diseases in maintenance hemodialysis patients

目的探讨维持性血液透析(MHD)患者营养不良、炎症和心血管疾病的发生情况及三者之间的关系。方法 67例MHD患者通过SGA评分、人体测量和血生化指标进行营养评估,测量高敏C反应蛋白(hs-CRP)作为炎症标记物并记录心血管并发症。分析营养状况、炎症及心血管并发症的关系。结果根据SGA评分营养不良的发生率为49.3%。营养不良组hs-CRP高于营养正常组(P<0.05)。hs-CRP升高者22例(32.8%),其白蛋白(ALB)水平低于正常者(P<0.05)。hs-CRP与SGA分值、ALB、血肌酐(Scr)负相关(P<0.05)。合并心血管并发症者ALB、preALB低于无并发症者,而hs-CRP高于无并发症者(P<0.05)。67例患者营养不良、炎症及动脉粥样硬化(MIA)综合征的发生率为17.9%。结论部分MHD患者存在MIA综合征,营养不良与炎症相互影响,二者可能共同参与心血管疾病的发生。

Objective To study the relationship between malnutrition, inflammation and cardiovascular diseases（CVD） in maintenance hemodialysis patients（MHD）. Methods 67 MHD patients were ehrolled. Subjective global assessment（SGA）,anthropometric measurements and biochemical parameters were used to assess nutritional status, hs-CRP was measured as a marker of inflammation. The incidence of CVD was recorded. The relationship between malnutrition, inflammation and CVD was analyzed. Results 33 （49.3%）patients were malnourished according to SGA. hs-CRP was higher in malnourished patients than in normal nutrition ones（ P 〈 0.05）. There were 22 patients（32. 8% ）whose hs-CRP exceeded normal level, while their ALB were lower than those with normal hs- CRP （ P 〈 0. 05 ）. hs-CRP was negatively correlated to SGA, ALB and Scr（ P 〈 0. 05 ）. ALB and preALB were lower in patients with CVD than those without CVD, while hs-CRP appeared to the contrary （ P 〈 0. 05）. The incidence of malnutrition,inflammation and atherosclerosis（MIA syndrome）was 17.9%. Conclusions MIA syndrome is present in MHD patients. There is interaction between malnutrition and inflammation those had the link with CVD.