对比罗沙司他、rHuEPO对腹膜透析患者外周血TIBC/Hb、血压及心脑血管并发症的影响  

Comparison of the effects of rosacetam and rHuEPO on peripheral blood TIBC/Hb, blood pressure, and cardiovascular and cerebrovascular complications in peritoneal dialysis patients

作　　者：杨剑 李金涛[1] 周美兰 YANG Jian;LI Jin-tao;ZHOU Mei-lan(Department of Nephrology,Baoji Traditional Chinese Medicine Hospital,Baoji Shaanxi 721000,China;Department of Nephrology,The First Affiliated Hospital of Air Force Military Medical University(Xijing Hospital),Xi'an Shaanxi 710032,China)

机构地区：[1]宝鸡市中医医院肾内科,陕西宝鸡721000 [2]空军军医大学第一附属医院(西京医院)肾内科,陕西西安710032

出　　处：《临床和实验医学杂志》2023年第21期2273-2277,共5页Journal of Clinical and Experimental Medicine

基　　金：2022年陕西省级科技计划项目(编号:2022SF-274)。

摘　　要：目的探究罗沙司他、重组人血红素(rhEPO)对腹膜透析患者外周血总铁结合力(TIBC)/血红蛋白(Hb)、血压及心脑血管并发症的影响差异。方法前瞻性选取2020年1月至2021年12月在宝鸡市中医医院进行腹膜透析的98例肾性贫血患者,按照随机数字表法将其分为观察组(n=50)和对照组(n=48)。对照组患者给予rHuEPO治疗,观察组患者给予罗沙司他治疗。检测两组患者治疗前、治疗12个月后铁代谢指标[TIBC、血清铁蛋白(SF)、血清铁(SI)、外周血血红蛋白(Hb)]、心功能指标[血清N末端B型利钠肽(NT-proBNP)、肌钙蛋白I(TnI)]、血压(收缩压、舒张压)和心脏彩超指标[室间隔厚度(IVS)、左心室后壁厚度(LVPW)及左心室射血分数(LVEF)]。记录所有患者不良事件发生情况。结果治疗12个月后,观察组TIBC、外周血Hb以及LVEF分别为(95.61±10.27)μmol/L、(102.53±10.19)g/L、(61.93±4.12)%,均高于对照组[(86.52±8.19)μmol/L、(95.44±8.53)g/L、(59.87±5.41)%],SI、SF、NT-proBNP、TnI、收缩压、舒张压、IVS、LVPW分别为(12.54±2.00)μmol/L、(256.04±21.20)ng/mL、(188.51±22.73)ρmol/L、(0.032±0.008)ng/mL、(125.07±10.14)mmHg、(85.04±4.72)mmHg、(10.00±1.10)mm、(9.89±1.02)mm,均低于对照组[(14.91±0.98)μmol/L、(267.12±18.73)ng/mL、(323.29±30.55)ρmol/L、(0.075±0.019)ng/mL、(130.03±11.22)mmHg、(89.62±10.25)mmHg、(11.79±1.72)mm、(11.24±1.95)mm],差异均有统计学意义(P<0.05)。治疗期间,观察组不良事件发生率为4.00%,低于对照组(18.75%),差异有统计学意义(P<0.05)。两组均无患者死亡。结论与rHuEPO相比,罗沙司他可显著改善腹膜透析患者铁代谢功能,同时对其心功能和血压影响更小,降低心脑血管并发症发生风险。Objective To investigate the differences in the effects of rosacetam and recombinant human heme(rhEPO)on total iron binding capacity(TIBC)/hemoglobin(Hb),blood pressure,and cardiovascular and cerebrovascular complications in patients undergoing peritoneal dialysis.Methods A prospective study was conducted on 98 patients with renal anemia who underwent peritoneal dialysis at Baoji Traditional Chinese Medicine Hospital from January 2020 to December 2021.They were divided into the observation group(n=50)and the control group(n=48)using a random number table method.The control group was treated with rHuEPO,while the observation group was treated with rosacetam.The iron metabolism indicators[TIBC,serum ferritin(SF)/serum iron(SI),peripheral blood hemoglobin(Hb)],cardiac function indicators[serum N-terminal B-type natriuretic peptide(NT proBNP),troponin I(TnI)]before and after 12 months of treatment Blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)]and cardiac color ultrasound indicators[interventricular septum thickness(IVS),left ventricular posterior wall thickness(LVPW)and left ventricular ejection fraction(LVEF)]were tested in two groups before and after 12 months of treatment.The occurrence of adverse events in two groups was recorded.Results After 12 months of treatment,the TIBC,peripheral blood Hb,and LVEF in the observation group were(95.61±10.27)μmol/L,(102.53±10.19)g/L,and(61.93±4.12)%,respectively,which were higher than those in the control group[(86.52±8.19)μmol/L,(95.44±8.53)g/L,and(59.87±5.41)%].SI,SF,NT-proBNP,TnI,systolic blood pressure,diastolic blood pressure,IVS,and LVPW in the observation group were(12.54±2.00)μmol/L,(256.04±21.20)ng/L,and(188.51±22.73)pmol/L,(0.032±0.008)ng/mL,(125.07±10.14)mmHg,(85.04±4.72)mmHg,(10.00±1.10)mm,and(9.89±1.02)mm,respectively,which were lower than those in the control group[(14.91±0.98)μmol/L,(267.12±18.73)ng/mL,(323.29±30.55)pmol/L,(0.075±0.019)ng/mL,(130.03±11.22)mmHg,(89.62±10.25)mmHg,(11.79±1.72)mm,(11.24±1.95)mm,t

关 键 词：腹膜透析 贫血 罗沙司他 RHUEPO 铁代谢 并发症 

分 类 号：R692.5[医药卫生—泌尿科学]