罗沙司他联合高通量血液透析对慢性肾脏病患者钙磷代谢及总铁结合力的影响  

Effects of roxadustat combined with high-flux hemodialysis on calcium and phosphorus metabolism and total iron binding capacity in patients with chronic kidney disease

作　　者：裴姝文 李妍 于歌[3] PEI Shuwen;LI Yan;YU Ge(Department of Nephrology,Harbin the First Hospital,Harbin 150010,Heilongjiang Province,China;Department of Critical Care Medicine,Harbin the First Hospital,Harbin 150010,Heilongjiang Province,China;Department of Gynecology,Harbin Medical University Cancer Hospital,Harbin 150081,Heilongjiang Province,China)

机构地区：[1]哈尔滨市第一医院肾内科,黑龙江哈尔滨150010 [2]哈尔滨市第一医院重症医学科,黑龙江哈尔滨150010 [3]哈尔滨医科大学附属肿瘤医院妇科,黑龙江哈尔滨150081

出　　处：《世界临床药物》2023年第12期1302-1307,共6页World Clinical Drug

基　　金：国家卫生健康委科学技术研究所项目(2021HX01408)。

摘　　要：目的 探讨罗沙司他联合高通量血液透析(high-flux hemodialysis,HFHD)对慢性肾脏病(chronic kidney disease,CKD)患者钙磷代谢及总铁结合力(total iron binding capacity,TIBC)的影响。方法 选择2021年1月至2022年12月于哈尔滨市第一医院肾内科确诊的接受HFHD的CKD患者80例,根据随机数字表法分为对照组和观察组,每组40例。对照组接受重组人促红细胞生成素联合HFHD,观察组接受罗沙司他联合HFHD。对比两组疗效、贫血相关因子[红细胞比容(hematocrit,HCT)、血红蛋白(hemoglobin,Hb)]、铁代谢相关因子[TIBC、转铁蛋白(transferrin,TRF)、TRF饱和度(transferrin saturation,TSAT)]、钙磷代谢相关因子[血钙、血磷、甲状旁腺激素(parathyroid hormone,PTH)]、血清炎症相关因子[肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-6、C反应蛋白(C-reactive protein,CRP)]及不良反应发生率。结果 观察组治疗总有效率高于对照组(92.50%vs 75.00%,P <0.05)。观察组不良反应发生率低于对照组(7.50%vs 20.00%,P <0.05)。观察组Hb、HCT、TIBC、TRF、TSTA水平较前均升高(P <0.05),且观察组高于对照组(P <0.05)。观察组血钙、血磷、PTH、TNF-α、IL-6、CRP水平较前均下降(P <0.05),且观察组低于对照组(P <0.05)。结论 罗沙司他联合HFHD可显著改善CKD患者的铁代谢、钙磷代谢、贫血及炎症情况,且安全性较佳。Objective To explore the effects of roxadustat combined with high-flux hemodialysis(HFHD) on calcium and phosphorus metabolism and total iron binding capacity(TIBC) in patients with chronic kidney disease(CKD).Methods A total of 80 CKD patients diagnosed with HFHD in the department of nephrology,Harbin the first hospital from January 2021to December 2022 were selected and divided into control group and observation group according to random number table method,with 40 cases in each group.The control group received recombinant human erythropoietin combined with HFHD,and the observation group received roxadustat combined with HFHD.Efficacy,anemia related factors[hematocrit(HCT),hemoglobin(Hb)],iron metabolism related factors[TIBC,transferrin(TRF),TRF saturation(TSAT)],calcium and phosphorus metabolism related factors[serum calcium,serum phosphorus,parathyroid hormone(PTH)],serum inflammatory factors[tumor necrosis factor(TNF)-α,interleukin(IL)-6,C-reactive protein(CRP)],and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of observation group was higher than that of control group(92.50% vs 75.00%,P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(7.50% vs 20.00%,P<0.05).The levels of Hb,HCT,TIBC,TRF and TSTA in observation group were higher than before treatment(P<0.05),and the levels in observation group were higher than those in control group(P<0.05).The levels of serum calcium,serum phosphorus,PTH,TNF-α,IL-6 and CRP in observation group were all decreased(P<0.05),and the levels in observation group were lower than those in control group(P<0.05).Conclusion Roxadustat combined with HFHD can significantly improve iron metabolism,calcium and phosphorus metabolism,anemia and inflammation in patients with CKD,with good safety.

关 键 词：罗沙司他 高通量血液透析 慢性肾脏病 钙磷代谢 总铁结合力 

分 类 号：R692[医药卫生—泌尿科学]