罗沙司他胶囊治疗初始腹膜透析肾性贫血的临床体会

Clinical experience of roxastat capsule in the treatment of renal anemia caused by initial peritoneal dialysis

目的观察罗沙司他治疗初始腹膜透析患者肾性贫血的效果。方法选取医院收治的腹膜透析合并肾性贫血的患者为研究对象。2019年1月~12月的患者为对照组,术后应用重组人促红细胞生成素。2020年1月~9月的患者为观察组,观察组患者置管后应用罗沙司他;两组同时口服铁剂治疗并规律随访12周。比较两组治疗前及治疗后血红蛋白、铁代谢指标(血清铁、转铁蛋白饱和度、血清铁蛋白)。比较不同随访时点血红蛋白变化;根据基线不同贫血程度分为不同亚组,对比治疗12周后不同亚组的血红蛋白变化值。观察两组患者用药期间的不良反应。结果观察组20例,对照组30例。治疗12周后观察组血红蛋白(109.2±16.38)g/L,对照组(92.23±19.62)g/L,两组间差异有统计学意义;两组治疗前后对比差异有统计学意义。观察组转铁蛋白饱和度、血清铁蛋白高于对照组,差异有统计学意义,观察组血清铁低于对照组,差异无统计学意义。不同贫血程度的患者对采用罗沙司他进行初始治疗的反应性存在差异。结论在腹膜透析肾性贫血患者初始诱导治疗阶段,口服罗沙司他较皮下注射红细胞生成刺激剂有更好的疗效,尤其对于中、重度贫血人群效果更佳。

Objective To observe the therapeutic effect of rosaxastat on renal anemia in patients with initial peritoneal dialysis.Methods Selected patients with renal anemia on peritoneal dialysis admitted to the hospital from January 2019 to September 2020 as the research objects.Patients from January 2019 to December 2019 served as the control group and received recombinant human erythropoietin after surgery.Patients from January to September 2020 were in the observation group.Patients in the observation group were treated with rosarestat after intubation;the two groups were treated with iron at the same time and followed up regularly for 12 weeks.The hemoglobin and iron metabolism indexes(serum iron,transferrin saturation TSAT,serum ferritin)before and after treatment were compared between the two groups.The changes in hemoglobin at different follow-up points were compared;the hemoglobin changes in different subgroups were compared according to different levels of anemia at baseline,and the hemoglobin changes in different subgroups after 12 weeks of treatment were compared.Observe the adverse reactions during the treatment of the two groups of patients.Results There were 20 cases in the observation group and 30 cases in the control group.After 12 weeks of treatment,hemoglobin in the observation group was(109.2±16.38)g/L and the control group(92.23±19.62)g/L.The difference between the two groups was statistically significant;the difference between the two groups before and after treatment was statistically significant.The transferrin saturation TSAT and serum ferritin SF of the observation group were higher than those of the control group,and the difference was statistically significant.The serum iron of the observation group was lower than that of the control group,and the difference was not statistically significant.Patients with different degrees of anemia differ in their responsiveness to the initial treatment with rosastat.Conclusion In the initial induction treatment of patients with renal anemia on peritoneal dialysis,oral rosastat has a better effect than subcutaneous injection of erythropoiesis stimulants,especially for people with moderate to severe anemia.