维持性血液透析患者营养不良-炎症综合征与肌少症的相关性

目的 探讨维持性血液透析患者营养不良-炎症综合征与肌少症之间的关系.方法 选择2014年10月至2015年12月在云南省肾脏病医院及昆明医科大学第一附属医院接受维持性血液透析患者55例,所有入组患者均用MIS评分法进行营养不良-炎症综合征的评估,应用生物电阻抗法进行肌肉质量测量,采用电子握力计测量肌力,空腹检测血生化指标.结果 本研究中肌少症患者26例(47.3％),其中肌少症前期患者10例(18.2％),肌少症期16例(29％),无肌少症29例(52.7％);肌少症前期、肌少症期、无肌少症三组患者年龄、性别差异有统计学意义(P＜0.05).按MIS得分将患者分为轻度(0～4分)、中度(5～8分)、重度(＞8分)三组.MIS评分与骨骼肌质量、骨骼肌质量指数、握力呈负相关(P＜0.05).不同MIS组间骨骼肌质量、骨骼肌质量指数、握力平均值差异有统计学意义(P＜0.05).结论 本组患者肌少症与患者年龄、性别相关.随着营养不良炎症得分增加,骨骼肌质量、骨骼肌质量指数及握力平均值呈下降趋势.改善维持性血液透析患者营养不良炎症状态可能会降低肌少症的发生.

Corelation of malnutrition inflammation complex syndrome and sarcopenia

Objective To investigate the relationship of malnutrition inflammation complex syndrome (MICS) in maintenance hemodialysis(MHD) patients with sarcopenia.Methods A total of 55 patients undergoing continuous ambulatory peritoneal dialysis and maintenance hemodialysis in Yurman Kidney Disease Hospital and The First Affiliated Hospital of Kunming Medical University from October 2014 to December 2015 were chosen.MIS was used to assess the malnutrition inflammation score,using multifrequency bioelectrical impedance in maintenance hemodialysis patients.Hand grip strength was measured and the laboratory index was used to assess the malnutrition of patients.Results There were 26 patients who suffered from the sarcopenia(47.3％),patients with early sarcopenia in 10 cases (18.2％),patients with sarcopenia in 16 cases (29％),and no sarcopenia in 29 cases(52.7％).The differences of age and gender between the three groups showed statistical significance (P ＜ 0.05).According to the MIS score,the objects were divided into mild group (0-4),moderate group (5-8),and severe group (＞ 8).MIS scores had statistically significance and negative correlation with quality of skeletal muscle,skeletal muscle mass index and grip strength (P ＜ 0.05).The differences of skeletal muscle,skeletal muscle mass index and grip strength among the three groups had statistically significance (P ＜ 0.05).Conclusion Sarcopenia may associate with age and gender.As malnutrition inflammation score increased,the quality of skeletal muscle,skeletal muscle quality index and average of grip strength are on the decline.Improving the state of malnutrition in patients with MHD inflammation may reduce the sarcopenia.