Study Of The Application Of Malnutrition-Inflammation Score(MIS) In Maintenance Hemodialysis Patients

Objective:The malnutrition inflammation complex syndrome(MICS) occurscommonly in maintenance hemodialysis(MHD) patients. And also, it is one ofthe important reasons of death in MHD patients. The malnutrition maycorrelate with the special state of MHD patients. The latent inflammationincreases the catabolism, which makes the nutrition of MHD patients hardto improve. Therefore, MICS was bring forward, and most doctors agree withit. But, how to assess the MICS in order to treat the patients better is ahot topic both at home and abord. Now most doctors at home use the SubjectiveGlobal Assessment(SGA) to assess the MICS; The research overseas show thatMIS may be superior to the conventional SGA, as well as to individuallaboratory values, as a predictor of dialysis outcome and indicator ofMICS. In this research, we compare the MIS to SGA, and assess the applicationof MIS by the effect of Yiqigushen (益气固肾) liquid on MHD patients.Methods:Fist the MIS was translated into Chinese, and make the criteriaof the method to measure the index in MIS. The clinic trial withcomparison, randomized control was taken. The patients were randomly dividedinto treatment group (37patients), and control group (35 patients). Thetreatment group dialyze with bicarbonate dialysate and Yiqigushen liquidat the same time, the control group dialyze with bicarbonate dialysate. Theperiod of the observation is 6 months, every index of MIS was measured andrecorded, including 1. dialysis dry weight change in the past 3-6months, 2. Dietary intake, 3. Gastrointestinal(GI)symptoms, 4. Functionalcapacity, 5. Co-morbidity including number of years on Dialysis, 6.Decreased fat stores or loss of subcutaneous fat, 7. Signs of musclewasting, 8. Body mass index, 9. Serum albumin, 10. serum transferrin arex. Thepatients with hypertension or heart failure were treated and recorded.After the clinic observation, we set up the date-base and copy the clinic data to it with the SPSS13 software and Statistical analysis was done.Results:MIS correlated with SGA in the value of patients of MHD. But, therewere also some differences between them. Patients in treatment group showedthe lower MIS compared to control group (P＜0.05) Furthermore, the scoresin appetite and the symptom such as nausea or vomit depressed than beforein treatment group, also the triceps skinfold(TSF), arm circumference(AC),Serum Albumin(ALB),serum transferrin(SF) increased than before (P＜0.05).But the change in control group was no value in statistics.Conclusion:1. The MIS correlates with SGA in the value of patients of MHD, and is superiorto SGA, especially to assess the hospitalization and mortality.2. The therapeutic of Yiqigushen liquid to MHD patients is effective, it canreduce the MIS in MHD patients. Then may reduce the mortality and frequencyof hospitalization.3. The therapeutic of Yiqigushen liquid can improve the nortrution of theMHD patients, It can increase the TSF,AC,ALB,SF of the patients. At thesame time, it improve the apetite and lighten the symptom such as nauseaor vomit of the patients.