罗沙司他对老年血液透析患者的疗效  

Efficacy of Roxadustat in Older Patients Undergoing Hemodialysis

作　　者：李起奉 刘树军[2] 鲁新[1] Li Qifeng;Liu Shujun;Lu Xin(Department of Nephrology,Jilin People's Hospital,Jilin 132000;Department of Nephrology,the Second Hospital of Jilin Uni versity,Changchun 130041)

机构地区：[1]吉林市人民医院肾病内科,吉林132000 [2]吉林大学第二医院肾病内科,长春130041

出　　处：《国际老年医学杂志》2022年第6期725-728,共4页International Journal of Geriatrics

摘　　要：目的 比较罗沙司他与外源性促红素在老年血液透析患者中的有效性及安全性。方法选取吉林市人民医院及吉林大学第二医院2020年5~12月期间接受维持性血液透析的278例慢性肾脏病(CKD)患者进行回顾性分析,按照年龄将患者分为老年组(≥60岁)192例和非老年组(<60岁)86例,根据治疗方案将老年组分为观察组(使用罗沙司他)100例及对照组(使用外源性促红素)92例,非老年组均使用罗沙司他。对比分析年龄、性别、收缩压、血红蛋白、铁蛋白、转铁蛋白饱和度、血清铁、总铁结合力、C反应蛋白(CRP)、二氧化碳结合力、血钾及白细胞介素6(IL-6)等一般及临床资料。结果 观察组收缩压、转铁蛋白饱和度、IL-6、CRP及二氧化碳结合力降低程度均大于对照组(P<0.05),观察组铁蛋白、血清铁及总铁结合力升高程度均大于对照组(P<0.05)。在使用罗沙司他的患者中,观察组血钾升高程度明显小于非老年组(P<0.05),观察组二氧化碳结合力降低更明显(P<0.05)。结论 罗沙司他作为治疗CKD相关性贫血的新兴药物,在老年透析患者中,可以降低炎症反应发生,提高铁的利用及吸收,降低血压。但更易引发酸中毒,必要时应予以预防性治疗。Objective To compare the efficacy and safety of roxadustat and exogenous erythropoietin in geriatric hemodialysis patients.Methods A retrospective analysis was performed on 278 patients undergoing maintenance hemodialysis from May 2020 to December 2020 in Jilin People’s Hospital and the Second Hospital of Jilin University.According to the age, the patients were divided into an elderly group(192 cases aged≥60 years) and a non-elderly group(86 cases aged<60 years).The elderly group was subdivided into an observation group(100 cases received roxadustat),and a control group(92 cases received exogenous erythropoietin) according to the treatment plan.The non-elderly group received roxadustat.General and clinical data were analyzed, including the age, gender, systolic blood pressure, hemoglobin, ferritin, transferrin saturation, serum ion, total iron binding capacity, C-reactive protein(CRP),carbon dioxide combining power, blood potassium, interleukin-6(IL-6).Results The levels of reduction of systolic blood pressure, transferrin saturation, IL-6,CRP and carbon dioxide binding capacity in the observation group were greater than those in the control group(P<0.05),and the levels of increase of ferritin, serum iron and total iron binding capacity in the observation group were greater than those in the control group(P<0.05).In the patients taking roxadustat, the level of increase of serum potassium in the elderly group(observation group) was significantly less than that in the non-elderly group(P<0.05),and the level of reduction of carbon dioxide combining power in the elderly group was greater(P<0.05).Conclusion As a new drug for the treatment of chronic kidney disease related anemia, roxadustat may reduce the occurrence of inflammatory reaction, improve the utilization and absorption of iron, and lower blood pressure in older patients with hemodialysis.However, it is more likely to cause acidosis, and preventive treatment should be given if necessary.

关 键 词：慢性肾脏病 血液透析 贫血 罗沙司他 

分 类 号：R692[医药卫生—泌尿科学]