幽门螺杆菌感染对维持性血液透析患者微炎症状态及营养状态的影响

Effects of Helicobacter pylori infection on microinflammation and nutritional status in maintenance hemodialysis patients

目的分析维持性血液透析患者幽门螺杆菌(HP)感染情况,探讨HP感染对维持性血液透析患者微炎症状态及营养状态的影响。方法回顾性分析2019年6月至2020年9月淮安市第二人民医院收治的维持性血液透析患者254例。对其HP感染情况进行分析。治疗3个月时,检测患者肿瘤坏死因子α(TNF-α)、血清白细胞介素6 (IL-6)、超敏C反应蛋白(hs-CRP)水平以评估微炎症状态;测量患者三头肌皮褶厚度(TSF)以评估脂肪储存情况;记录患者体重及血清营养指标包括白蛋白(ALB)、前白蛋白(PAB)、血红蛋白(Hb)水平;应用主观性综合性营养评估法(SGA)评估患者营养状态,并计算营养不良发生率。结果本组254例维持性血液透析患者中,54例患者伴HP感染(HP感染组),HP感染率为21.3%;200例患者无HP感染(无HP感染组)。HP感染组患者TNF-α、IL-6、hs-CRP水平均高于无HP感染组患者,TSF小于无HP感染组患者,ALB、PAB、Hb水平均低于无HP感染组患者,营养不良发生率高于无HP感染组患者,且差异均有统计学意义(P均<0.05)。结论维持性血液透析患者伴HP感染。相对于HP感染者而言,无HP感染者微炎症状态更轻,营养状态更佳。

Objective To investigate the Helicobacter pylori(Hp) infection in maintenance hemodialysis patients,and to explore the effects of Hp infection on microinflammation and nutritional status of the patients.Methods A total of 254 maintenance hemodialysis patients admitted to Huai’an Second People’s Hospital from June 2019 to September 2020 were retrospectively analyzed.The Hp infection of the study subjects were analyzed,and the patients were grouped according to the presence or absence of Hp infection.After 3 months of treatment,the levels of tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6) and hypersensitive C-reactive protein(hs-CRP) were measured to assess the microinflammatory status.Triceps skin fold thickness(TSF) was measured to assess fat storage.Body mass and serum nutritional indexes including albumin(ALB),prealbumin(PAB) and hemoglobin(Hb) levels were recorded.Subjective global assessment of nutritional status(SGA) was used to assess the nutritional status of patients and calculate the incidence of malnutrition.Results Of the 254 patients,54 patients were accompanied by Hp infection(Hp infection group),and the Hp infection rate was 21.3%.No Hp infection was found in 200 patients(no Hp infection group).The levels of TNF-α,IL-6 and hs-CRP in patients with Hp infection were higher than those in patients without Hp infection.The levels of TSF,ALB,PAB and Hb in patients with Hp infection were lower than those in patients without Hp infection.The incidence of malnutrition in patients with Hp infection was higher than that in patients without Hp infection.The differences were statistically significant(all P<0.05).Conclusions Maintenance hemodialysis patients are accompanied by Hp infection.Compared with those infected with Hp,patients without Hp infection show less microinflammation and better nutritional status.