罗沙司他联合rHuEPO治疗老年维持性血液透析伴肾性贫血患者的疗效及对铁代谢的影响  

Efficacy of roxadustat combined with rHuEPO in treatment of elderly patients with renal anemia undergoing maintenance hemodialysis and its effect on iron metabolism

作　　者：刘桂林 任直亲 夏丽萍 Liu Guilin;Ren Zhiqin;Xia Liping(Blood Purification Center,Jiaozhou Central Hospital,Qingdao,Shandong,266300,P.R.China)

机构地区：[1]青岛市胶州中心医院血液净化中心,山东青岛266300

出　　处：《老年医学与保健》2024年第5期1425-1428,1438,共5页Geriatrics & Health Care

基　　金：2022—2024年青岛市市级临床重点专科肾脏病学(血液净化)专科资助(青卫政字〔2022〕6号)。

摘　　要：目的评估罗沙司他与重组人促红细胞生成素(rHuEPO)联合治疗方案在老年维持性血液透析(MHD)患者中针对肾性贫血的治疗效果,并分析其对患者铁代谢的潜在影响。方法回顾性分析2019年6月—2023年6月青岛市胶州中心医院316例老年MHD伴肾性贫血患者的临床资料,分为3组:A组(103例)用rHuEPO治疗,B组(108例)用罗沙司他治疗,C组(105例)用罗沙司他联合rHuEPO治疗,经倾向性评分匹配法,各组基线无统计学差异。比较3组的疗效、铁代谢水平[血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)、运铁蛋白(TF)水平]、血细胞参数水平[红细胞计数(RBC)、血细胞比容(Hct)、血红蛋白(Hb)]及不良反应发生情况。结果治疗后,C组总有效率>B组>A组,差异具有统计学意义(P<0.05);3组铁代谢各指标水平和血细胞参数各指标水平均显著高于同组治疗前,且C组>B组>A组(P<0.05),C组治疗前后差值绝对值>B组>A组(P<0.05);3组不良反应发生率差异无统计学意义(P>0.05)。结论罗沙司他和rHuEPO联合治疗老年MHD伴肾性贫血患者,疗效显著,可增强人体对铁元素的吸收与应用效率,改善老年患者贫血状态,具有一定的临床应用价值。Objective To evaluate the effects of roxadustat combined with recombinant human erythropoietin(rHuEPO)in the treatment of renal anemia in elderly maintenance hemodialysis(MHD)patients and analyze its potential effect on iron metabolism of the patients.Methods The clinical data of 316 elderly patients with renal anemia undergoing MHD in Jiaozhou Central Hospital of Qingdao City from June 2019 to June 2023 were retrospectively analyzed.They were divided into 3 groups:Group A(103 cases)treated with rHuEPO,group B(108 cases)treated with roxadustat,and group C(105 cases)treated with roxadustat combined with rHuEPO.There was no significant difference in baseline among all groups by propensity score matching.The therapeutic effect,iron metabolism level[serum ferritin(SF),transferrin saturation(TSAT)and transferrin(TF)],blood cell parameter level[RBC count(RBC),hematocrit(Hct)and hemoglobin(Hb)]and the incidence of adverse reactions were compared among the three groups.Results After treatment,the total effective rate was group C>group B>group A,and the differences were statistically significant(P<0.05).The levels of various indicators of iron metabolism and blood cell parameters of the three groups were significantly higher than those of the same group before treatment,and group C>group B>group A(P<0.05).The absolute difference before and after treatment in the group C was greater than that in the other two groups(group B>group A)(P<0.05).There was no statistically significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion The combination therapy of roxadustat and rHuEPO has significant therapeutic effects on elderly patients with renal anemia undergoing MHD.It can enhance the absorption and application efficiency of iron in the human body,improve the anemia status of elderly patients,and has certain clinical application value.

关 键 词：老年 罗沙司他 铁代谢 维持性血液透析 肾性贫血 血细胞参数 重组人促红细胞生成素 

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