Abstract: Objective　To explore the influence of malnutrition-inflammatory complex syndrome（MICS）on the quality of life of patients with maintenance hemodialysis（MHD）.Methods　The research samples,70 patients who received MHD in the First Affiliated Hospital of Kunming Medical University and Yunnan Kidney Disease Hospital from October 2014 to December 2015 were selected.According to scores of malnutrition-inflammation（MIS）,patients were separated into 3 groups,involving mild group（n=19）,moderate group（n=29）,and severe group（n=22）.The nutrition and inflammatory index of patients in three groups were detected,and short form health survey questionnaire（SF-36） was used to evaluate their quality of life,and the correlations between MIS and patients’ age,nutrition and inflammatory index,and SF-36 scores were investigated.Results　The incidence rate of included patients was 100.0%,average MIS scores of patients in mild,moderate and severe group were（2.7±1.0）,（6.1±0.9）,and（10.9±2.2）.There was significant difference in grip strength,serum ferritin（SF）,high-sensitivity C-reactive protein（hs-CRP）,and tumor necrosis factor α（TNF-α） among patients in 3 groups（P<0.05）;while there was no significant difference in prealbumin（PA） and interleukin-6（IL-6,P>0.05）.Pearson correlation analysis showed that there was a linearly positive correlation between MIS and age,TNF-α（P<0.05）,there was a linearly negative correlation between MIS and grip strength（P<0.05）,and MIS and PA showed no linearly correlation（P>0.05）;Spearman rank correlation analysis presented that MIS was positive correlated with SF and hs-CRP（P<0.05）,and not correlated with IL-6（P>0.05）.There was significant difference in scores of role physical（RP） and total scores of the scale among patients in three groups（P<0.05）;While there was no significant difference in scores of physical function（PF）,body pain（BP）,general health（GH）,energy state（Energy）,social function（SOCF）,role emotional（RE）,emotion well-being（EWB） and physical health（PH）,mental health（MH） score（P>0.05）.Pearson correlation analysis showed that MIS was linearly negatively correlated with PH scores（P<0.05）,and was not linearly correlated with scores of GH and Energy（P>0.05）;Spearman rank correlation analysis manifested that MIS was negatively correlated with PF,RP and total scores of scale（P<0.05）,and was not correlated with scores of BP,SOCF,RE,EWB and MH（P>0.05）.Conclusion　The incidence rate of MICS of MHD patients is high,the more severe MICS is,the more obvious grip strength reduces,the more severe inflammatory state is,the worse overall quality of life is.

Key words: Renal dialysis, Malnutrition-inflammation complex syndrome, Quality of life

摘要： 目的　探讨营养不良-炎性反应综合征（MICS）对维持性血液透析（MHD）患者生活质量的影响。方法　选取2014年10月—2015年12月在昆明医科大学第一附属医院、云南肾脏病医院接受MHD的患者70例。根据营养不良-炎性反应评分（MIS），将纳入患者分为轻（n=19）、中（n=29）、重（n=22）3组。检测3组患者的营养及炎性指标，采用生存质量量表（SF-36）评价其生活质量，并探讨MIS与患者年龄、营养及炎性指标、SF-36得分的相关性。结果　纳入患者的MICS发生率为100.0%，轻、中、重3组患者的平均MIS分别为（2.7±1.0）、（6.1±0.9）、（10.9±2.2）分。3组患者握力、血清铁蛋白（SF）、超敏C反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）比较，差异有统计学意义（P<0.05）；而前清蛋白（PA）、白介素6（IL-6）比较，差异无统计学意义（P>0.05）。Pearson相关分析结果显示，MIS与年龄、TNF-α呈直线正相关（P<0.05），与握力呈直线负相关（P<0.05），与PA无直线相关关系（P>0.05）；Spearman秩相关结果显示，MIS与SF、hs-CRP呈正相关（P<0.05），与IL-6不相关（P>0.05）。3组患者体力所致工作和生活受限（RP）、量表总得分比较，差异有统计学意义（P<0.05）；而体能（PF）、躯体疼痛（BP）、总体健康（GH）、精力状况（Energy）、社会功能（SOCF）、情感所致工作和生活受限（RE）、情感状况（EWB）及生理领域（PH）、心理领域（MH）得分比较，差异无统计学意义（P>0.05）。Pearson相关分析结果显示，MIS与PH得分呈直线负相关（P<0.05），与GH、Energy得分无直线相关关系（P>0.05）；Spearman秩相关结果显示，MIS与PF、RP及量表总得分呈负相关（P<0.05），与BP、SOCF、RE、EWB及MH得分不相关（P>0.05）。结论　MHD患者的MICS发生率较高，MICS程度越重，患者握力减轻越明显，炎性状态越严重，总体生活质量越差。

关键词: 肾透析, 营养不良-炎性反应综合征, 生活质量