低氧诱导因子脯氨酰羟化酶抑制剂治疗血液透析患者贫血的效果观察  

Clinical effect of hypoxia-inducible factor prolyl hydroxylase inhibitor for treating anemia in hemodialysis patients

作　　者：王鑫[1] 朱楠[1] 曾婉 陆晓青[1] 王沛[1] WANG Xin;ZHU Nan;ZENG Wan;LU Xiao-qing;WANG Pei(Blood Purification Center,First Affiliated Hospital of Zhengzhou Unirersity,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院血液净化中心,河南郑州450052

出　　处：《中国实用内科杂志》2023年第11期928-932,共5页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(82370747)。

摘　　要：目的 分析低氧诱导因子脯氨酰羟化酶抑制剂(罗沙司他)治疗血液透析患者贫血的长期疗效。方法 选择2020至2022年郑州大学第一附属医院血液净化中心的80例血液透析患者,采取自身前后对照设计方法,回顾性分析患者应用罗沙司他前及用药后随访3年的血红蛋白(Hb)、血清铁、转铁蛋白饱和度、铁蛋白、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、钙、磷、甲状旁腺素、白蛋白、血钾水平。结果 80例血液透析患者平均透析龄(5.45±1.63)年,原发疾病以肾小球肾炎为主,31例占38.75%。血液透析患者使用罗沙司他前Hb水平为(102.80±14.91)g/L,使用罗沙司他后1个月、3个月、6个月、12个月、24个月、36个月Hb水平分别为(105.91±11.60)g/L、(107.24±10.65)g/L、(110.09±12.72)g/L、(111.20±12.69)g/L、(109.03±11.55)g/L、(110.59±12.15)g/L。使用罗沙司他后的Hb水平高于使用前(P<0.001),使用后血红蛋白逐步升高,在使用后6个月左右维持在目标值稳定状态。使用罗沙司他后的铁蛋白、转铁蛋白饱和度水平高于使用前(P<0.001)。应用罗沙司前后,患者的血清铁、血脂、血钾、钙、磷、甲状旁腺素、白蛋白水平差异均无统计学意义(P>0.05)。结论 罗沙司他有效改善及长期维持血液透析患者Hb水平,改善铁利用,对肾性贫血具有较好的应用效果。Objective To analyze the efficacy of hypoxia-inducible factor prolyl hydroxylase inhibitor(Roxadustat)in the treatment of anemia in hemodialysis patients.Methods After inclusion and exclusion,80 hemodialysis patients were included in First Affiliated Hospital of Zhengzhou Unirersity between 2020 and 2022.The self-controlled design was used to retrospectively analyze the levels of hemoglobin(Hb),serum iron,transferrin saturation,ferritin,total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein,calcium,phosphorus,parathyroid hormone,albumin,and blood potassium of patients before and after the application of Roxadustat and during 3 years of follow-up.Results The average dialysis age of 80 hemodialysis patients was(5.45±1.63)years.The primary disease was mainly glomerulonephritis,with 31 cases accounting for 38.75%.Hemodialysis patients had Hb levels of(102.80±14.91)g/L before using Roxadustat,and(105.91±11.60)g/L,(107.24±10.65)g/L,(110.09±12.72)g/L,(111.20±12.69)g/L,(109.03±11.55)g/L,and(110.59±12.15)g/L at 1 month,3 months,6 months,12 months,24 months,and 36 months after using Roxadustat,respectively.The Hb level after use of Roxadustat was higher than before use(P<0.001),and the hemoglobin gradually increased after use,maintaining a stable target value for about 6 months after use.The levels of ferritin and of saturation transferrin after the use of Roxadustat were higher than those that before use(P<0.001).There were no statistically significant changes in serum iron,blood lipids,potassium,calcium,phosphorus,parathyroid hormone,and albumin levels before or after the application of Roxadustat(P>0.05).Conclusion Roxadustat effectively improves and maintains Hb levels in hemodialysis patients,improves iron utilization,and has a good therapeutic effect on renal anemia.

关 键 词：血液透析 肾性贫血 罗沙司他 

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