罗沙司他对维持性腹膜透析患者血压的影响  

Influence of Roxadustat on blood pressure in peritoneal dialysis patients

作　　者：赵玉超 赵慧萍[1] 武蓓[1] 朱丽 芦丽霞[1] 左力[1] 王梅[1] ZHAO Yu-chao;ZHAO Huiping;WU Bei;ZHU Li;LU Li-xia;ZUO Li;WANG Mei(Department of Nephrology,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院肾内科,北京100044

出　　处：《中国血液净化》2022年第9期633-637,共5页Chinese Journal of Blood Purification

基　　金：北京市首都市民健康培育专项基金(Z161100000116070)。

摘　　要：目的探讨罗沙司他对于维持性腹膜透析患者血压的影响。方法采用回顾性自身对照研究,纳入2019年1月~2020年8月在北京大学人民医院肾内科规律随访、应用罗沙司他至少4个月且在应用罗沙司他前应用重组人红细胞生成素(recombinant human erythropoietin,rHuEPO)至少1年的维持性腹膜透析(peritoneal dialysis,PD)患者。将rHuEPO转换为罗沙司他的时间定义为基线时间,收集患者基线资料、应用罗沙司他后每个月的临床资料,共收集4个月,同时收集1年前同期患者应用rHuEPO期间的临床资料。比较应用罗沙司他后与基线时以及罗沙司他期间与1年前相同月份应用rHuEPO期间患者的血压、血红蛋白(Hb)、降压药物剂量等的变化。结果共38例PD患者纳入研究,基线收缩压(systolic blood pressure,SBP)为(144.6±18.5)mmHg,应用罗沙司他1月、2月、3月、4月后,SBP分别为(139.2±17.5)mmHg、(134.3±15.9)mmHg、(137.4±16.9)mmHg和(137.2±14.5)mmHg,均较基线SBP下降(1月:t=2.285,P=0.028;2月:t=3.408,P=0.002;3月:t=2.223,P=0.032;4月:t=2.521,P=0.030),降压药物的限定日剂量较基线无统计学差异。结论排除了季节、容量、降压药物剂量等可能影响血压的因素后,PD患者将rHuEPO转换为罗沙司他,可有效避免rHuEPO相关血压升高。Objective To assess the influence of Roxadustat on blood pressure in peritoneal dialysis(PD)patients through a retrospective,self-controlled cohort study.Methods PD Patients who were treated with Roxadustat for at least 4 months,and were treated with rHuEPO for at least 1 year before the application of Roxadustat were enrolled in this study.Baseline clinical data and the clinical data of each month after the application of Roxadustat were collected for a total of 4 months.Clinical data of patients during the same period of 1 year ago when patients were treated with rHuEPO were also collected.Compare the differences between baseline and after taking Roxadustat,and the difference between Roxadustat phase and rHuEPO phase.Results A total of 38 PD patients were enrolled in the study.Systolic blood pressure(SBP)at baseline was 144.6±18.5 mmHg,after taking Roxadustat for 1 month,2 months,3 months and 4 months,SBP was 139.2±17.5 mmHg,134.3±15.9 mmHg,137.4±16.9 mmHg and 137.2±14.5 mmHg respectively.SBP decreased after taking Roxadustat compared with baseline(1 month:t was 2.285,P was 0.028;2 month:t was 3.408,P was 0.002;3 month t was 2.223,3 month P was 0.032;4 month t was 2.521,P was 0.030 respectively).There were no significant differences in defined daily dose of anti-hypertensive drugs after Roxadustat treatment compared with baseline.Conclusion After switching rHuEPO to Roxadustat,hypertension caused by rHuEPO can be avoided after excluding factors that may affect blood pressure in PD patients,such as season,volume,and dose of antihypertensive drugs.

关 键 词：腹膜透析 肾性贫血 低氧诱导因子 罗沙司他 血压 

分 类 号：R459.5[医药卫生—治疗学]