罗沙司他治疗老年维持性血液透析患者肾性贫血的疗效和安全性

Efficacy and safety of Roxadustat in treatment of renal anemia in elderly maintenance hemodialysis patients

目的观察罗沙司他治疗老年维持性血液透析患者肾性贫血的疗效和安全性。方法选择2020年1~12月六安市人民医院收治的维持性血液透析合并肾性贫血的老年患者50例,采用随机数字表法将患者分为观察组和对照组,每组25例。观察组患者予以口服罗沙司他胶囊治疗,对照组患者予以静脉注射重组人促红素注射液治疗。两组患者均予以口服琥珀酸亚铁片,疗程24周。比较干预前后两组患者血红蛋白(Hb)、红细胞压积(Hct)、血清铁(SI)、总铁结合力(TIBC)、转铁蛋白饱和度(TSAT)、转铁蛋白(TF)、血清铁蛋白(SF)、C反应蛋白(CRP)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)指标变化情况及不良反应发生情况。结果治疗前,两组患者Hb、Hct、SI、TIBC、TSAT、TF、SF、CRP、TC、TG、HDL、LDL比较,差异均无统计学意义(P均>0.05)。观察组Hb、Hct、SI、TIBC、TSAT、TF治疗前后差值高于对照组(P均<0.05),SF、CRP、TC、TG、HDL、LDL治疗前后差值低于对照组(P均<0.05)。治疗期间两组不良反应发生情况比较,差异无统计学意义(χ^(2)=0.149,P=0.700)。结论罗沙司他可纠正老年血液透析患者的贫血状况,促进铁的吸收和利用,还能改善患者炎症状态,调节脂质代谢。

Objective To observe the clinical efficacy and safety of Roxadustat in the treatment of renal anemia in elderly maintenance hemodialysis patients.Methods Fifty elderly maintenance hemodialysis patients with renal anemia in Lu’an People’s Hospital from January 2020 to December 2020 were selected and randomly divided into observation group(25 cases)and control group(25 cases).The patients in the observation group were given oral Roxadustat capsule,and the patients in the control group were given intravenous Recombinant Human Erythropoietin Injection.Both groups of patients were given oral ferrous succinate tablets.Patients in two groups were treated for 24 weeks.The levels of hemoglobin(Hb),hematocrit(Hct),serum iron(SI),total iron binding capacity(TIBC),transferrin saturation(TSAT),transferrin(TF),serum ferritin(SF),C-reactive protein(CRP),total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL)indicators before and after intervention were compared between the two groups.Besides,the occurrence of adverse reactions was compared between the two groups.Results There was no significant difference in Hb,Hct,SI,TIBC,TSAT,TF,SF,CRP,TC,TG,HDL,LDL between the two groups before treatment(all P>0.05).The levels of Hb,SI,TIBC,TSAT,TF and Hct in the observation group before and aftert reatment were higher than those in the control group,and the difference was statistically different(all P<0.05),while the levelsof SF,CRP,TC,TG,HDL and LDL before and after treatment were lower than those in the control group,and the difference was statistically different(all P<0.05).Besides,there was no significant difference inthe occurrence of adverse reactions between the two groups during treatment(χ^(2)=0.149,P=0.700).Conclusions For elderly hemodialysis patients,Roxadustat can improve anemia and promote the absorption and utilization of iron.In addition,Roxadustat can also improve inflammatory state and regulate lipid metabolism.