维持性血液透析患者发生营养不良-炎症-动脉粥样硬化综合征的影响因素及与预后的关系

doi:10.3969/j.issn.1006-6233.2025.09.030

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Abstract Objective: To explore the occurrence and related influencing factors of malnutrition-inflammation-atherosclerosis syndrome (MIAS) in patients with maintenance hemodialysis (MHD), and to analyze the relationship between MIAS and prognosis in MHD patients, so as to provide evidence for the prevention and treatment of MIAS in MHD patients. Methods: The medical records of 160 MHD patients who received treatment in the hospital from March 2022 to March 2023 were retrospectively collected, and the occurrence of MIAS was investigated. Patients were divided into MIAS group (n=41) and non-MIAS group (n=119) according to whether MIAS occurred or not. The clinical data were compared between the two groups, The relationship of hypersensitive C-reactive protein (hs-CRP), carotid intima-media thickness (IMT) and albumin (ALB) with interleukin-6 (IL-6), transferrin (TRF), immunoinflammatory index (SII) and malnutrition-inflammation score (MIS) in MIAS patients was analyzed by pearson correlation coefficient. Logistic regression model was used to analyze the independent risk factors of MIAS in MHD patients. According to the 1-year follow-up results, MHD patients were divided into good prognosis group (n=132) and poor prognosis group (n=28), and the differences in clinical data and MIAS prevalence were compared between groups, and the relationship between MIAS and prognosis in MHD patient was explored by Logistic regression analysis. Results: MIAS occurred in 41 cases among 160 MHD patients, and the incidence of MIAS was 25.63%. Serum hs-CRP, IMT, IL-6, SII and MIS score in MIAS group were higher than those in non-MIAS group while serum ALB and TRF were lower than those in non-MIAS group (P<0.05). Serum hs-CRP and IMT in MHD patients were positively correlated with serum IL-6, SII and MIS score, and were negatively correlated with serum TRF (P<0.05). Serum ALB in MHD patients was negatively correlated with IL-6, SII and MIS score, and positively correlated with serum TRF (P<0.05). High serum IL-6, SII and MIS score, and low serum TRF were independent risk factors for MIAS in MHD patients (P<0.05). Serum IL-6, serum SII, MIS score and MIAS prevalence rate in poor prognosis group were higher than those in good prognosis group while serum TRF was lower than that in good prognosis group (P<0.05). Increased serum IL-6 and SII, decreased serum TRF, high MIS score and concurrent MIAS were independent risk factors of poor prognosis in MHD patients (P<0.05). Conclusion: MIAS is common in MHD patients. Increased serum IL-6, SII and MIS score and decreased serum TRF are independent risk factors of MIAS and poor prognosis in MHD patients, and MIAS is closely related to prognosis in MHD patients.

Key words： Maintenance hemodialysis Malnutrition Inflammation Atherosclerosis Status quo Influencing factors

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.09.030 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I9/1579

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