维持性血液透析患者生活质量与营养不良和微炎症的相关性

摘要

目的 探讨维持性血液透析(MHD)患者生活质量与营养不良和微炎症状态的关系.方法 选择解放军第180医院2015年4月至2016年10月期间治疗的70例MHD患者为研究对象,检测血清超敏C反应蛋白(hs-CRP)水平并调查改良定量主观整体评估表(MQSGA)评分、SF-36量表评分,分析血清hs-CRP和MQSGA评分与SF-36量表评分的关系.结果 70例MHD患者中营养不良者26例,正常营养者44例,营养不良发生率为37.14％,hs-CRP≥8 mg/L者32例,hs-CRP<8 mg/L者38例,微炎症状态发生率为45.71％;营养不良组患者SF-36量表PCS、MCS及综合评分分别为(53.18±6.24)分、(52.25±5.29)分、(55.04±4.63)分,均明显低于正常营养组的(56.89±8.37)分、(55.69±6.72)分、(58.24±6.92)分,差异均有统计学意义(P<0.05);hs-CRP≥8 mg/L组患者PCS、MCS及综合评分分别为(53.28±8.39)分、(54.06±6.59)分、(54.97±7.68)分,均明显低于hs-CRP<8 mg/L组的(57.74±9.46)分、(58.13±8.43)分、(58.12±9.37)分,差异均有统计学意义(P<0.05);Spearman相关分析显示,MQSGA与SF-36量表评分呈正相关性(r=0.348,P<0.05),hs-CRP则与SF-36量表评分呈负相关性(r=-0.359,P<0.05).结论 MHD患者营养不良及微炎症状态的发生率较高,且与患者的生活质量关系密切.%Objective To investigate the relationship between quality of life with malnutrition and micro in-flammatory status in patients with maintenance hemodialysis (MHD) patients. Methods A total of 70 patients with MHD, who admitted to the 180th Hospital of Chinese PLA from April 2015 to October 2016, were selected as the re-search objects. The levels of serum high sensitivity C reactive protein (hs-CRP) were detected and the modified quanti-tative subjective global assessment scale (MQSGA) score and SF-36 score were investigated in these patients, and the relationships between serum hs-CRP and MQSGA score with SF-36 score were analyzed. Results There were 26 cas-es of malnutrition and 44 cases of normal nutrition in 70 cases of MHD patients, with the malnutrition rate of 37.14％;hs-CRP≥8 mg/L group included 32 cases, and hs-CRP<8 mg/L included 38 cases, with microinflammatory state rate of 45.71％; the PCS, MCS and SF-36 comprehensive scores in the malnutrition group were (53.18 ± 6.24), (52.25 ± 5.29), (55.04 ± 4.63), respectively, which were significantly lower than corresponding (56.89 ± 8.37), (55.69 ± 6.72), (58.24±6.92) in the normal nutrition group (P<0.05);the PCS, MCS and SF-36 comprehensive scores in hs-CRP≥8 mg/L group were (53.28±8.39), (54.06±6.59), (54.97±7.68), respectively, which were significantly lower than corre-sponding (57.74 ± 9.46), (58.13 ± 8.43), (58.12 ± 9.37) in hs-CRP<8 mg/L group (P<0.05). Spearman correlation analysis showed that MQSGA score was positively correlated with SF-36 score (r=0.348,P<0.05), while hs-CRP score was nega-tively correlated with SF-36 score (r=-0.359,P<0.05). Conclusion The incidence of malnutrition and microinflamma-tory in patients with MHD is high, which is closely related to the quality of life of patients.