罗沙司他对尿毒症维持性血液透析肾性贫血患者的疗效影响及作用机制研究

Efficacy and mechanism of roxadustat on uremic maintenance hemodialysis patients with renal anemia

目的探讨罗沙司他对尿毒症维持性血液透析肾性贫血患者的疗效影响及其作用机制。方法选择2018年5月至2021年1月南京市中心医院收治的100例尿毒症维持性血液透析肾性贫血患者为研究对象,依照治疗方法不同分为对照组(60例)和研究组(40例)。对照组接受重组人促红+素注射液治疗,研究组接受罗沙司他治疗,两组均治疗12周。对比两组临床疗效,对比两组治疗前后低密度脂蛋白(low density lipoprotein,LDL)、甘油三酯(triacylglycerol,TG)、血清C反应蛋白(C-reactive protein,CRP)、转铁蛋白饱和度、铁蛋白、铁调素水平,对比两组药物安全性。结果研究组总有效率(90.00%)高于对照组(77.33%),差异有显著性(P<0.05);治疗前,两组LDL、TG水平比较,差异无显著性(P>0.05);治疗12周后,两组LDL、TG水平均降低(P<0.05),且研究组更低(P<0.05);治疗前,两组血清CRP水平比较,差异无显著性(P>0.05);治疗12周后,两组血清CRP水平均降低(P<0.05)且研究组更低,差异有显著性(P<0.05);治疗前,两组血清转铁蛋白饱和度、铁蛋白、铁调素水平比较,差异无显著性(P>0.05);治疗12周后,两组血清转铁蛋白饱和度水平均升高,且研究组更高,差异有显著性(P<0.05);治疗12周后,两组血清铁蛋白、铁调素水平均降低且研究组更低,差异有显著性(P<0.05);两组治疗12周内不良反应发生率比较,差异无显著性(P>0.05)。结论罗沙司他治疗尿毒症维持性血液透析肾性贫血患者疗效显著,可改善患者血脂代谢水平,减轻机体炎症反应,安全可靠,且其作用机制与调节铁代谢密切相关。

Objective To investigate the effect of roxadustat on the effect of roxadustat on uremic maintenance hemodialysis patients with renal anemia and its mechanism.Method A total of 100 patients with renal anemia in uremic maintenance hemodialysis who were admitted to the hospital from May 2018 to January 2021 were selected as the research objects,and divided into control group(n=60)and study group(n=40)according to different treatment methods.The control group received recombinant human erythropoietin injection treatment,and the study group received roxadustat treatment,both groups were treated for 12 weeks.The clinical efficacy of the two groups were compared.The levels of low-density lipoprotein(LDL),triacylglycerol(TG),serum C-reactive protein(CRP),transferrin saturation,ferritin and hepcidin were compared between the two groups before and after treatment.The safety of the two groups of drugs was compared.Result The total effective rate of the study group(90.00%)was higher than that of the control group(77.33%)(P<0.05).Before treatment,there were no significant difference in LDL and TG levels between the two groups(P>0.05).After 12 weeks of treatment,the levels of LDL and TG in both groups were decreased(P<0.05),and the study group was lower(P<0.05).Before treatment,there were no significant difference in serum CRP levels between the two groups(P>0.05).After 12 weeks of treatment,serum CRP levels in both groups were decreased,and the study group was lower(P<0.05).Before treatment,there was no significant difference in serum transferrin saturation,ferritin and hepcidin levels between the two groups(P>0.05).After 12 weeks of treatment,serum transferrin saturation levels in both groups were increased,and higher in the study group(P<0.05).After 12 weeks of treatment,the levels of serum ferritin and hepcidin in both groups were decreased,and the study group was lower(P<0.05).There were no significant difference in the incidence of adverse reactions between the two groups within 12 weeks of treatment(P>0.05).Conclusion Roxadustat was effective in the treatment of uremic maintenance hemodialysis patients with renal anemia.It could improve the blood lipid metabolism and reduce the body’s inflammatory response.It was safe and reliable,and its mechanism of action was closely related to the regulation of iron metabolism.