营养不良-炎症状态对老年血液透析病人生存质量影响

Effect of malnutrition-inflammation status on the quality of life of elderly hemodialysis patients

目的:探讨老年血液透析病人营养不良-炎症状态与生存质量关系。方法:选取老年血液透析病人103例,分别采用营养不良-炎症评分法(MIS)和肾病生存质量专用量表(KDQOL-SFTM)进行调查,其结果与临床营养、炎症指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、体质量指数(BMI)、前白蛋白(ALB)、血红蛋白]进行相关性分析和多元线性分析,探索影响生存质量因素。结果:MIS评分结果:营养不良发生率为83.5%(86/103);KDQOL-SFTM评分结果:肾病、透析相关生存质量(KDTA)为(52.86±9.65),一般健康相关生存质量(SF-36)为(48.74±16.32);相关性分析显示SF-36评分与CRP、IL-6、MIS评分、透析史呈负相关(P<0.05~P<0.01),与BMI呈正相关(P<0.01);KDTA评分与CRP和年龄呈负相关(P<0.01和P<0.05),与ALB呈正相关(P<0.01);多元线性回归分析显示,随着BMI值增高、IL-6和MIS降低,SF-36增高;随着CRP降低、ALB增高,KDTA总评分增高(P<0.05~P<0.01)。结论:老年血液透析病人营养不良发生率较高,而生存质量水平较低;BMI、IL-6、MIS是SF-36重要影响因素;CRP、ALB是KDTA重要影响因素。积极纠正营养不良-炎症状态有利于改善病人生存质量。

Objective:To investigate the relationship between malnutrition-inflammatory status and quality of life in elderly hemodialysis patients.Methods:One hundred and three elderly patients with hemodialysis were investigated using malnutrition inflammation score(MIS)combined with kidney disease quality of life short form(KDQOL-SFTM),and the relationship between the results of which and clinical nutritional,inflammatory indicators[C reactive protein(CRP),interleukin-6(IL-6),body mass index(BMI),albumin(ALB),hemoglobin]were analyzed using the correlation and multivariate linear analysis to explore the influencing factors of quality of life.Results:The results of MIS showed that the incidence rate of malnutrition was 83.5%(86/103).The results of ADQOL-SFTM showed that the score of kidney disease-targeted areas(KDTA)was(52.86±9.65),and the score of short form health survey questionnaire 36(SF-36)was(48.74±16.32).The results of correlation analysis showed that the SF-36 score was positively correlated with BMI score(P<0.01),and negatively correlated with the scores of CRP,IL-6 and MIS(P<0.05 to P<0.01).The KDTA score was positively correlated with ALB score(P<0.01),and negatively correlated with the scores of CRP and age(P<0.01 and P<0.05).The results of multiple linear regression analysis showed that the SF-36 score increased,and the scores of IL-6 and MIS decreased with the increasing of BMI.With the decreasing of CRP,the score of ALB increased,and the total KDTA score increased(P<0.05 to P<0.01).Conclusions:The incidence rate of malnutrition in elderly hemodialysis patients is higher,and the quality of life is lower.The BMI,IL-6 and MIS are important influencing factors of SF-36,and the CRP and ALB are important influencing factors of KDTA.Correcting the state of malnutrition and inflammation is helpful to improve the quality of life of patients.