罗沙司他对维持性血液透析患者肾性贫血的疗效及铁、脂代谢的影响  

Effect of Roxadustat on Renal Anemia and Influence on Iron and Lipid Metabolism in Maintenance Hemodialysis Patients

作　　者：胡菂菂[1] 李恩就[1] 刘娜 张艳霞 HU Didi;LI Enjiu;LIU Na;ZHANG Yanxia(Jiangmen Central Hospital,Guangdong Province,Jiangmen 529000,China;不详)

机构地区：[1]广东省江门市中心医院,广东江门529000 [2]南方医科大学顺德医院附属杏坛医院

出　　处：《中国医学创新》2023年第14期50-55,共6页Medical Innovation of China

基　　金：广东省江门市科技计划项目(2021YL01073)。

摘　　要：目的:研究罗沙司他纠正维持性血液透析(MHD)肾性贫血的效果及对铁、脂代谢的影响。方法:将2019年12月-2021年12月江门市中心医院及南方医科大学顺德医院附属杏坛医院收治的98例MHD肾性贫血的患者列入研究对象,按随机数字表法平均分为两组,各49例,对照组给予人促红素注射液治疗,观察组给予罗沙司他治疗,比较两组临床疗效、不良反应,以及治疗前后贫血、铁代谢、血脂代谢、炎症指标的变化。结果:与治疗前相比,治疗12周后,两组贫血指标[血红蛋白(Hb)、血红细胞计数(RBC)、红细胞压积(Hct)]和转铁蛋白饱和度(TS)均明显升高(P<0.05),观察组低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)、高密度脂蛋白胆固醇(HDL-C)均明显降低(P<0.05),观察组血清铁(Fe)、铁蛋白(SF)、转铁蛋白(TRF)、总铁结合力(TIBC)和对照组TRF均明显升高(P<0.05),且治疗12周后观察组贫血指标(Hb、RBC、Hct)、血清Fe、铁代谢指标(SF、TRF、TIBC、TS)、脂代谢指标(LDL-C、HDL-C、TG、TC)、炎症指标(WBC、hs-CRP)均优于对照组(P<0.05)。观察组总有效率明显比对照组高(P<0.05)。治疗期间,观察组不良反应总发生率明显比对照组低(P<0.05)。结论:罗沙司他用于纠正MHD肾性贫血的效果明显,优于常规人促红素注射液治疗,耐受性好,可明显改善贫血状态及铁、脂代谢,减轻机体炎症反应。Objective:To study the effect of Roxadustat on the correction of renal anemia in maintenance hemodialysis(MHD)and its influence on iron and lipid metabolism.Method:A total of 98 patients with MHD renal anemia admitted to Jiangmen Central Hospital and Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University from December 2019 to December 2021 were included in the study.They were divided into two groups according to the random number table method,49 patients in each group.The control group was treated with Human Erythropoietin Injection,and the observation group was treated with Rosastal.The clinical efficacy,adverse reactions,and the changes of anemia index,iron metabolism index,blood lipid metabolism index and inflammation index before and after treatment between the two groups were compared.Result:Compared with before treatment,after 12 weeks of treatment,the anemia indicators[hemoglobin(Hb),red blood cell count(RBC),and hematocrit(Hct)]and transferrin saturation(TS)in both groups were significantly increased(P<0.05),and low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglycerides(TG),white blood cell count(WBC),hypersensitive C reactive protein(hs-CRP),high-density lipoprotein cholesterol(HDL-C)in the observation group were significantly decreased(P<0.05),serum iron(Fe),ferritin(SF),transferrin(TRF),total iron binding capacity(TIBC)in the observation group and TRF in the control group were significantly increased(P<0.05),and anemia indicators(Hb,RBC,Hct),serum iron,iron metabolism indicators(SF,TRF,TIBC,TS),lipid metabolism indicators(LDL-C,HDL-C,TG,TC),and inflammatory indicators(WBC,hs-CRP)in the observation group after 12 weeks of treatment were better than those in the control group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).During the treatment period,the total incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:R

关 键 词：罗沙司他 铁代谢 脂代谢 维持性血液透析 肾性贫血 

分 类 号：R692.5[医药卫生—泌尿科学] R556[医药卫生—外科学]