罗沙司他对不同铁代谢状态维持性血液透析患者贫血的影响  

Roxadustat on anemia in maintenance hemodialysis patients with different iron metabolism status

作　　者：郑光毅 洪大情[2] 李贵森[2] 何敬东[3] 张萍 张振华 邓菲[6] 魏锦曦 何东[8] 周莲卉 杨冬梅 张燕[1] 薛痕[1] ZHENG Guangyi;HONG Daqing;LI Guisen;HE Jingdong;ZHANG Ping;ZHANG Zhenhua;DENG Fei;WEI Jinxi;HE Dong;ZHOU LianHui;YANG Dongmei;ZHANG Yan;XUE Hen(Department of Nephrology,Ya'an People's Hospital,Ya'an 625000,China;Renal Department and Nephrology Institute,Sichuan Provincial People's Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610072,China;National Nuclear Corporation 416 Hospital,Chengdu 610000,China;Department of Nephrology,Gao Xin Boli Hospital,Chengdu 610000,China;Department of Nephrology,The People's Hospital of Ziyang,Ziyang 641300,China;Department of Nephrology,Chengdu Jinniu District People’s Hospital,Chengdu 610036,China;Hemodialysis center,Pidu District People’s Hospital,Pidu 611730,China;Department of Nephrology,The People’s Hospital of Mianyang,Mianyang 621000,China;Department of Nephrology,The People’s Hospital of Chongzhou,Chongzhou 611200,China;Department of Nephrology,Anzhou District People’s Hospital of Mianyang City,Mianyang 622650,China)

机构地区：[1]雅安市人民医院肾内科,雅安625000 [2]四川省人民医院肾病研究所 [3]核工业四一六医院 [4]高新博力医院肾内科 [5]资阳市人民医院肾内科 [6]四川省人民医院金牛医院肾内科 [7]郫都区人民医院血透中心 [8]绵阳市人民医院肾内科 [9]崇州市人民医院肾内科 [10]绵阳市安州区人民医院肾内科

出　　处：《肾脏病与透析肾移植杂志》2021年第6期536-540,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：四川省科技厅课题(2019JDPT0007);雅安市人民医院科研课题(ysy2019001)。

摘　　要：目的:探究罗沙司他对不同铁代谢状态维持性血液透析(MHD)患者贫血的影响。方法:纳入四川省10个透析中心的MHD肾性贫血患者96例作为研究对象。根据患者基线血清铁蛋白(SF)水平分为SF正常组(SF≤500 ng/L)和铁过载组(SF>500 ng/L)。所有受试者根据体重给予罗沙司他治疗12周。检测治疗前后受试者血红蛋白(Hb)、铁代谢指标[SF、转铁蛋白饱和度(TSAT)、总铁结合力(TIBC)],监测治疗期间的不良反应。结果:SF正常组和铁过载组治疗后Hb明显上升(P<0.001),且两组Hb的变化量差异无统计学意义(P=0.897)。两组患者治疗后SF均较治疗前下降,TIBC均较治疗前上升(P均<0.05);但铁过载组SF下降幅度更大,而TIBC上升幅度较小;两组患者的TSAT均保持稳定。治疗过程中未发现严重不良反应。结论:不同铁代谢状态下,罗沙司他均可有效纠正贫血和改善铁代谢,但铁代谢得到改善的程度不同。Objective:To investigate the effect of Roxadustat on anemia in maintenance hemodialysis(MHD)patients with different iron metabolism status.Methodology:A prospective study,96 MHD patients with renal anemia from 10 dialysis centers in Sichuan Province were selected.According to the baseline serum ferritin(SF)level,the patients were divided into normal SF group(SF≤500 ng/L)and iron overload group(SF>500 ng/L).All subjects were treated with Roxadustat for 12 weeks according to their body weight.Hemoglobin(Hb),iron metabolism indexes[SF,transferrin saturation(TSAT),total iron binding capacity(TIBC)]were detected before and after treatment,and adverse reactions were monitored during treatment.Results:Hb in normal SF and iron overload group increased significantly compared with that before treatment(P<0.001),and there was no significant difference in Hb changes between the two groups(P=0.897).After treatment,SF decreased and TIBC increased in both groups,and the difference was statistically significant;however,SF decreased greatly and TIBC increased slightly in iron overload group.TSAT remained stable in both groups.No severe adverse reactions were found during the treatment.Conclusion:Roxadustat can effectively correct anemia and improve iron metabolism in different iron metabolism states,but there are different improvement degrees for iron metabolism.

关 键 词：维持性血液透析 铁负荷过度 肾性贫血 罗沙司他 铁代谢 

分 类 号：R692.5[医药卫生—泌尿科学]