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目的:比较营养不良-炎症评分(MIS)、改良SGA(MQSGA)和血清白蛋白三种维持性血液透析(MHD)患者营养评估方法,为选择MHD患者营养评估方法提供依据。方法:选取我院血透中心行MHD3个月以上患者为研究对象,观察指标:(1)营养不良指标:MIS、MQSGA和血清白蛋白。(2)人体测量学指标:体重指数(BMI)、肱三头肌皮褶厚度(TSF)、上臂围(MAC)、上臂肌围(MAMC)等。(3)生化指标:血清白蛋白、转铁蛋白、总胆固醇、肌酐、铁蛋白。统计分析MIS、MQSGA和白蛋白与其他营养指标的相关性,并对所有患者追踪1年,分为住院组和未住院组,比较两组中MIS、MQSGA和白蛋白的差异,然后建立COX比例风险模型,分析这3个指标与MHD患者住院风险有无关系。结果:(1)MIS标准:118例MHD患者全部为营养不良占100%;MQSGA标准:营养不良占74.57%;白蛋白标准:营养不良占16.95%。(2)白蛋白、MQSGA和MIS与血液生化和人体测量指标呈现相关性(P<0.05),但是以MIS与其他营养指标的相关系数最大。(3)118例MHD患者中,住院组MIS和MQSGA均显著高于未住院组(P<0.05)。(4)Cox风险比例模型显示MIS与患者住院风险有关。结论:MIS对营养不良的检出率最高,与其他营养评价指标的相关性更好,可以预测MHD患者的住院风险。
OBJECTIVE: To compare nutritional assessment of patients with malnutrition - inflammation score (MIS), modified SGA (MQSGA) and serum albumin in three maintenance hemodialysis (MHD) patients, and to provide a basis for selecting nutritional assessment methods for patients with MHD. Methods: We selected MHD patients with MHD of more than 3 months in our hospital as research objects, and observed the indicators: (1) Malnutrition indicators: MIS, MQSGA and serum albumin. (2) Anthropometric indicators: body mass index (BMI), triceps skinfold thickness (TSF), upper arm circumference (MAC), upper arm muscle circumference (MAMC) and so on. (3) biochemical indicators: serum albumin, transferrin, total cholesterol, creatinine, ferritin. Statistical analysis of MIS, MQSGA and albumin and other nutritional indicators, and all patients were followed up for 1 year, divided into hospital group and non-hospital group, comparing the two groups MIS, MQSGA and albumin differences, and then establish the proportion of COX Risk model, analysis of these three indicators and hospitalized patients with MHD risk whether or not. Results: (1) MIS criteria: All 118 cases of MHD patients were malnourished, accounting for 100%; MQSGA standard: malnutrition accounting for 74.57%; albumin standard: malnutrition accounting for 16.95%. (2) Albumin, MQSGA and MIS were correlated with blood biochemical and anthropometric indexes (P <0.05), but the correlation coefficients between MIS and other nutritional indexes were the highest. (3) Among 118 MHD patients, the MIS and MQSGA were significantly higher in hospitalized patients than in non-hospitalized patients (P <0.05). (4) Cox risk proportional model shows that MIS is related to the hospitalization risk of patients. Conclusion: MIS has the highest detection rate of malnutrition and the correlation with other nutrition evaluation indexes is better, which can predict the hospitalization risk of MHD patients.