| Objective:To research the influence of Malnutrition Inflammation Complex Syndrome (MICS) on the Health-Related Quality of life(HR-QL) of patients with Maintenance Hemodialysis (MHD).Methods:A total of 70 cases of MHD patients with 3 months or more of hemodialysis treatment in October 2014 to December 2015 in the first affiliated hospital of Kunming Medical University and Yunnan Kidney Disease Hospital were selected as the research object. The MIS score was used to determine its MICS, the Short Form Health Survey Questionnaire 36 (SF-36) scale was used to investigate the quality of life, with grip strength measured and biochemical indexes detected at the same time. According to the MIS score, the object were divided into mild group(0～ 4), moderate group(5-8), severe group(>8). The discrepancy of three groups were compared in the grip strength, micro inflammation index and quality of life, the relationship between MIS score with the index were investigated, the influence of different levels of MICS on the quality of life of patients with MHD were analyzed.Results:1.General status:70 MHD patients were selected in our study, the male 34 case (48.57%), female 36 case (51.43%), with an average of 46.59±15.01 years, mean duration of dialysis was 46.50 (20.00～74.25) months, mean MIS score was 6.69±3.5 Opoint (the minimum for 1 minute, up to 16 minute). According to the MIS diagnostic criteria for grading, into the group of hemodialysis patients the incidence of malnutrition-inflammatory syndrome amounted to 100%. The primary disease constitute:Chronic glomerulonephritis in 49 cases (70%) and diabetic nephropathy in 5 cases (7.1%), hypertensive nephrosclerosis in 3 patients (4.3%),2 cases of IgA nephropathy (2.9%), interstitial nephritis in 1 case (1.4%),1 case of obstructive nephropathy (1.4%),9 cases of not clear (12.9%).2. The comparison of three groups and correlation analysis of MIS score:The three groups are mild group ofl9 cases (27.14%), moderate group of29 cases (41.43%),and severe group of22 cases (31.43%).The differences of Grip strength, hs-CRP, TNF-α,and SF among the three groups have statistically significance (P< 0.05), While age, sex, PA, IL-6 were no statistical difference (P>0.05). hs-CRP, TNF-α and SF are positively correlated with MIS score of MHD patients (P< 0.05), while grip strength is negatively correlated with that of MHD patients (P< 0.05). The correlation analysis of Scoring for MIS and PA, IL-6 no statistical significance (P> 0.05).3. Malnutrition-inflammatory syndrome on the quality of life of patients with MHD: There were statistically significant differences among the three groups comparing the total score of SF-36 with that of the role limitation due to physical problems (RP) (P< 0.05), and MIS scores have negative correlation with SF-36 scores, physical function (PF), and the role limitation due to physical problems (RP)(P< 0.05). MIS scores have not statistical significance correlation with the body Pain (Pain), general health (GH), the emotional state (EWB), work and life caused by emotional limited (RE), the condition of social function (SOCF), Energy (Energy) (P> 0.05).Conclusion:1. The study found that MICS incidence of MHD patients with 3 months or more of hemodialysis treatment was 100%.2. MIS score can reflect MHD patients with malnutrition-inflammation state (MICS) systematically and completely, MIS as a more accurate quantitative evaluation system, is worth wide application in clinic.3. The higher score MIS gets, the more obviously grip strength reduces; the more serious inflammation, the worse the overall quality of life of MHD patients.4. MICS mainly from the physical field affects the patient’s quality of life, give priority to with both physical function (PF) and the role limitation due to physical problems (RP). |
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