Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
Nephrol Dial Transplant. 2012 Mar;27(3):1176-83. doi: 10.1093/ndt/gfr458. Epub 2011 Sep 5.
Patients undergoing maintenance hemodialysis (MHD) have a significantly higher prevalence of hepatitis C virus (HCV) infection and malnutrition-inflammation complex syndrome (MICS). In the present study of Taiwanese MHD patients, we determined the clinical characteristics and influence of HCV infection on MICS by calculation of the malnutrition-inflammation score (MIS).
This was a prospective longitudinal study performed at a single hemodialysis (HD) center in Taiwan from September 2007 through March 2008. The study enrolled 58 patients (38%) in the active HCV group and 95 patients (62%) in the non-HCV group. The two or three weekly HD sessions of all patients were followed for 7 months. The MIS was assessed using 10 components, 7 from the conventional subjective global assessment of nutrition and 3 additional elements, body mass index, serum albumin and total iron-binding capacity.
HD vintage and total MIS score were greater in patients with active HCV. The active HCV group had significantly longer dialysis vintage and lower total cholesterol but higher total MIS score than the non-HCV group. The MIS 5 score, a measure of major comorbid conditions (including number of years on dialysis), was also significantly higher in the active HCV group.
MHD patients with active HCV infections have more severe MICS-associated metabolic and physiological disease than MHD patients without active HCV infection.
接受维持性血液透析（MHD）的患者丙型肝炎病毒（HCV）感染和营养不良-炎症综合征（MICS）的患病率明显更高。在本研究中，我们通过计算营养不良-炎症评分（MIS）来确定台湾 MHD 患者的临床特征以及 HCV 感染对 MICS 的影响。
这是一项在台湾一家血液透析（HD）中心进行的前瞻性纵向研究，时间为 2007 年 9 月至 2008 年 3 月。该研究纳入了 58 例（38%）活跃 HCV 组和 95 例（62%）非 HCV 组患者。所有患者每 2 或 3 周进行一次 HD 治疗，随访 7 个月。MIS 使用 10 个组成部分进行评估，其中 7 个来自常规主观整体营养评估，另外 3 个是体重指数、血清白蛋白和总铁结合能力。
活跃 HCV 患者的 HD 年龄和总 MIS 评分较高。活跃 HCV 组的透析年龄较长，总胆固醇水平较低，但总 MIS 评分较高。MIS5 评分（衡量主要合并症的指标，包括透析年限）在活跃 HCV 组也显著较高。
与无活跃 HCV 感染的 MHD 患者相比，患有活跃 HCV 感染的 MHD 患者存在更严重的与 MICS 相关的代谢和生理疾病。
