罗沙司他在维持性血液透析患者肾性贫血治疗中的应用效果观察

Application effect observation of Roxadustat in the treatment of renal anemia in maintenance hemodialysis

目的观察罗沙司他治疗维持性血液透析(MHD)患者肾性贫血的有效性和安全性。方法选择2019年8—10月浙江省杭州市富阳区第一人民医院血液净化中心治疗的15例合并肾性贫血的MHD患者为研究对象,均接受外源性促红细胞生成素(EPO)治疗。患者停用EPO,应用铁剂者同时停用铁剂,1周后开始口服罗沙司他治疗,剂量为100~120 mg/次,3次/周,疗程12周。治疗前后检测血红蛋白以及血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]、铁蛋白的变化。记录治疗过程中的药物不良反应。结果治疗后血红蛋白水平较治疗前明显升高,铁蛋白明显降低,差异均有统计学意义(均P<0.05);治疗后,患者的TC、LDL水平较治疗前明显下降,差异均有统计学意义(均P<0.05);而患者的TG、HDL治疗前后无明显变化,差异无统计学意义(P>0.05);治疗过程中患者无明显药物相关的不良反应发生。结论罗沙司他可以有效治疗MHD患者的肾性贫血,可为临床提供一种全新的治疗手段。

Objective To observe the efficacy and safety of Roxadustat in the treatment of renal anemia in maintenance hemodialysis(MHD).Methods From August to October 2019,15 MHD patients with renal anemia treated by the Blood Purification Center of the First People’s Hospital of Fuyang District,Hangzhou City,Zhejiang Province were selected as the study subjects,all of them received exogenous erythropoietin(EPO)treatment.The patient stopped EPO,and the iron agent was stopped at the same time when the iron agent was applied.After one week,the oral Roxadustat treatment was started,with the dose of 100-120 mg/time,three times per week,and the course of treatment was 12 weeks.The changes of hemoglobin,blood lipid(triacylglycerol[TG],total cholesterol[TC],low-density lipoprotein(LDL),high-density lipoprotein[HDL])and ferritin were detected before and after treatment.Adverse drug reactions during treatment were recorded.Results After treatment,the hemoglobin level and ferritin level were significantly increased and decreased compared with those before treatment,with statistically significant differences(all P<0.05).After treatment,the TC and LDL levels of the patients were significantly decreased compared with those before treatment,and the differences were statistically significant(all P<0.05);however,TG and HDL of the patients did not change significantly before and after treatment,and the differences were not statistically significant(P>0.05).Conclusion Roxadustat can effectively treat renal anemia in MHD patients,which may provide a new treatment method for clinical practice.