| Objective:To explore the relationship between Malnutrition Inflammation Complex Syndrome (MICS) and cardiovascular calcification in Maintenance Hemodialysis (MHD) patients.Methods:Sixty patients with MHD≥3 months in The First Affiliated Hospital of Kunming Medical Universityand Yunnan Kidney Disease Hospital were enrolled into this respective study, completed the relevant laboratory examination, used the malnutrition inflammation score (MIS score) to test MHD patient’s MICS, the patients with MICS were divided into mild (MIS≤4), moderate (5≤MIS≤8) and severe group (MIS≥9).Abdominal aortic calcification score (AACS) was determined by abdominal lateral radiographs, and the valve calcification was examined by cardiac ultrasound,Results:1.general status:all enrolled patients (male/female:25 (41.7%)/35 (58.3%))with an average age of 46.57±14.61. The protopathy consist of chronic nephritis (71.7%), diabetic nephropathy(8.3%), hypertensive nephropathy(8.3%), lupus nephritis (3.3%) and HenochSchonleinpurpura nephritis in (1.6%), agnogenic (6.6%).2.Distribution of cardiovascular calcification:The cardiovascular calcification occurrence was 68.3%, the AAC occurrence was48.3%, the valve calcification occurrence was51.7%,both the AAC and valve calcification occurrence was 31.67%.3.The comparison of clinical data between the two groupswith or without cardiovascular calcification:The comparison of two groups in which patients with or without cardiovascular calcification showed significant difference in age, blood calcium, MIS score(P<0.05).4.The distribution of MICS:The MICS occurrence was 100%, including 19 cases (31.7%) in mild group,27 cases (45%) in moderate group,14 cases (23.3%) in severe group.5.The situation of cardiovascular calcification among different MIS group:were compared the occurrence of cardiovascular calcification, abdominal aorta calcification, cardiovascular calcification rates among different MIS groups. The results showed that with the MICS increased the occurrence of cardiac valve calcification also had an increase trend, and the difference was statistically significant (x2=7.702, P=0.021); but with the MICS increased the occurrence of cardiovascular calcification and AAC also have an increase trend, but the difference had no statistically significant (x2=3.25,073, P=0.197,0.694)6.The risk factors of cardiovascular calcification:Take whether the occurrence of cardiovascular calcification, calcification of the abdominal aorta, cardiac valve calcification respectively as the dependent variable and take the meaningful factors score (MIS, calcium and age)as independent variables, logistic regression analysis showed that MIS score was the risk factors of cardiac valve calcification (OR=1.298,95%CI 1.002 to 1.682), the difference was statistically significant (P= 0.042).Conclusion 1. MHD patients had widespread Malnutrition Inflammation Complex Syndrome (MICS).2. The occurrence of calcification have difference when parts of the heart valve is different, the incidence of aortic valve calcification is higher than that of the mitral valve.3. The higher the MIS score is, in other words the more severe the degree of malnutrition inflammation syndrome is, the more likely it is to occur calcification.4. The malnutrition inflammation syndrome was the risk factors of cardiac valve calcification, so all MHD patients should to accepte malnutrition inflammation complex syndrome screening, For the patients who have the syndrome to trace the cause and timely give treatment and nutrition education, as soon as possible to correct the camp in patients with malnutrition inflammation, reduce the risk of cardiac valve calcification. |
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