罗沙司他治疗维持性血液透析患者促红细胞生成素低反应性贫血的临床观察  

Roxadustat in maintenance hemodialysis patients with erythropoietin hyporesponsive anemia:A clinical observation retrospective study

作　　者：黄军悦[1] 陈婷 董慧 许丽丽 陈彩合 黄文辉[1] Huang Junyue;Chen Ting;Dong Hui;Xu Lili;Chen Caihe;Huang Wenhui(Department of Nephrology,Gansu Provincial Hospital,Lanzhou 730000,China;The First Clinical Medical College,Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院肾内科,甘肃兰州730000 [2]甘肃中医药大学第一临床医学院,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2023年第9期28-32,39,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省自然科学基金资助项目(22JR11RA251)。

摘　　要：目的观察罗沙司他治疗维持性血液透析(MHD)患者促红细胞生成素(EPO)低反应性贫血的疗效及安全性。方法回顾性纳入2020年5月-2021年8月在甘肃省人民医院血液净化中心接受MHD治疗的EPO低反应性贫血患者为研究对象,收集一般临床资料及血清学指标,分析罗沙司他治疗前后血清学指标及血压变化,同时记录药物不良反应。结果共纳入24例患者,其中17例患者完成6个月治疗。罗沙司他治疗前血红蛋白(Hb)为(79.94±17.08)g/L,红细胞压积(HCT)为(23.41±4.64)%,治疗后Hb为(104.82±21.32)g/L,HCT为(31.31±6.38)%,各值治疗前后差异均具有统计学意义(P<0.05)。治疗后血甘油三酯、胆固醇、铁蛋白、转铁蛋白饱和度均较治疗前降低,但差异无统计学意义(P>0.05)。血小板、血清钾、谷草转氨酶、谷丙转氨酶及甲状旁腺激素、白蛋白、C反应蛋白(CRP)治疗前后差异无统计学意义(P>0.05)。治疗期间,患者血压稳定,未出现肝功能异常、高钾血症、心脑血管意外等不良事件。结论在EPO低反应性贫血MHD的患者中,罗沙司他可以有效提升并维持Hb水平,且耐受性良好;同时,CRP水平在罗沙司他治疗EPO低反应性贫血中无影响。Objective To observe the efficacy and safety of Roxadustat in the treatment of erythropoietin(EPO)hyporesponsive anemia in maintenance hemodialysis(MHD)patients.Methods The subjects were MHD patients with EPO hypo-responsiveness in the Hemodialysis Center of Gansu Provincial Hospital from May 2020 to August 2021,whose general clinical data and serum indexes were collected.The changes in serum indexes and blood pressure before and after treatment with Roxadustat were analyzed retrospectively,and adverse events were recorded.Results A total of 24 patients were included,of whom 17 completed six months of treatment.Before treatment,the hemoglobin(Hb)was(79.94±17.08)g/L and hematocrit(HCT)was(23.41±4.64)%;after treatment,Hb was(104.82±21.32)g/L,HCT was(31.31±6.38)%,and the differences between before and after treatment were statistically significant(P<0.05).After treatment,blood triglyceride,total cholesterol,ferritin and transferrin saturation were lower than before,but the difference was not statistically significant(P>0.05).Platelet,serum potassium,aspartate aminotransferase alanine aminotransferase,parathyroid hormone,albumin and C-reactive protein(CRP)were not significantly different from before treatment(P>0.05).During the treatment,the patients'blood pressure were stable,no hepatic dysfunction,hyperkalemia,cardiovascular and cerebrovascular accidents and other adverse events occured.Conclusion Roxadustat can effectively improve and maintain hemoglobin levels in MHD patients with EPO hypo-responsiveness and has good tolerance.At the same time,CRP levels do not affect the treatment of EPO hypo-responsiveness.

关 键 词：罗沙司他 血液透析 促红细胞生成素 低反应性贫血 铁代谢 

分 类 号：R453.9[医药卫生—治疗学]