MHD患者营养不良-炎症综合征与营养风险及生存质量的相关分析

A correlation study on malnutrition inflammation complex syndrome with nutritional risk and life quality in patients with aintenance hemodialysis

目的 探讨维持性血液透析（maintenance hemodialysis,MHD）患者营养不良-炎症综合征（malnutrition inflammation complex syndrome,MICS）与营养风险及生存质量的相关性.方法 选择在昆明医科大学第一附属医院和云南肾脏病医院接受血液透析治疗≥3个月的61例透析患者为研究对象,用NRS2002进行营养风险筛查,用营养不良-炎症评分（MIS）来判断其MICS,用SF-36量表进行生存质量调查.并根据MIS评分将存在MICS的患者分为轻度（MIS≤4）、中度（5≤MIS≤8）、重度（MIS≥9）三组.结果 ①MIS评分在有、无营养风险两组患者之间差异有统计学意义（P＜0.01）,与NRS2002评分正相关（r=0.612,P＜0.01）;②不同MICS组间握力差异有统计学意义（P＜0.05）;③三组MICS组间比较体力所致工作和生活受限得分差异有统计学意义（P＜0.05）,MIS评分与SF-36总分、生理和心理领域、体能、体力所致工作和生活受限、社会功能呈负相关,差异有统计学意义（P＜0.05）;④有、无营养风险的两组MHD患者生存质量无差异（P＞0.05）.结论 MHD患者营养风险越高其营养不良-炎症综合征越严重,营养不良-炎症综合征越严重其生存质量越差.

Objectives To explore the correlation of malnutrition inflammation（MHD） complex syndrome with nutritional risk and life quality in patients with maintenance hemodialysis.Methods Sixty-one patients with MHD≥3 months in the first affiliated hospital of Kunming medical university and Yunnan kidney disease hospital were enrolled into this respective study,the NRS2002 was used to screen nutritional risk,the short form 36 health survey questionnaire （SF-36） scale was used to investigate the quality of life,the malnutrition inflammation score （MIS score） was used to test MHD patients＆#39; MICS,the patients with MICS were divided into mild （MIS≤4）,moderate （5 ≤ MIS ≤ 8） and severe group （MIS ≥9）.Results ①The comparison of MIS between the two groups in which patients with or without nutrition risk had statistically significant difference （P 〈 0.01）,The MIS and NRS2002 had a positive correlation （r =0.612,P 〈 0.01）.② The grip among the different MICS groups was statistically significant difference （P 〈 0.05）.③The comparison of limited working and living score caused by strength among the different MICS groups had statistically significant difference （P 〈 0.05）,and there were statistically significant differences in the MIS score and SF-36 scores,physiological and psychological fields,physical fitness,limited working and living score caused by strength,social function had a negative correlation （P 〈 0.05）.④The comparison of life quality between the two groups in which patients with or without nutrition risk had no difference （P 〉 0.05）.Conclusions For MHD patients,the higher the nutrition risk is,the more serious malnutrition inflammation complex syndrome will be,the more serious malnutrition inflammation complex syndrome is,the worse life quality will be.