罗沙司他联合重组人红细胞生成素治疗维持性血液透析肾性贫血临床观察

Clinical Observation of Roxadustat Combined with Recombinant Human Erythropoietin in the Treatment of Renal Anemia in Patients Undergoing Maintenance Hemodialysis

目的 探讨罗沙司他联合重组人红细胞生成素(rhEPO)治疗维持性血液透析(MHD)肾性贫血的临床疗效。方法 选取医院2020年7月至2021年9月收治行MHD的患者108例,按倾向评分匹配法分为观察组和对照组,各54例。两组患者均予肾性贫血常规治疗,并静脉注射rhEPO、口服琥珀酸亚铁片,观察组患者加服罗沙司他胶囊。结果 观察组患者治疗1个月及3个月后的红细胞计数、平均红细胞血红蛋白浓度均显著升高,铁蛋白水平显著降低,且均显著优于对照组(P <0.05);观察组患者治疗1个月、3个月后的血红蛋白、转铁蛋白饱和度、白蛋白/球蛋白、高密度脂蛋白胆固醇水平均显著升高,且治疗3个月后均显著优于对照组(P <0.05);观察组患者治疗1个月及3个月后的血清白蛋白水平均显著升高(P <0.05);观察组患者治疗3个月后的血肌酐水平显著降低(P <0.05)。观察组与对照组不良反应发生率相当(5.55%比3.70%,P> 0.05)。结论 罗沙司他联合rhEPO治疗MHD患者的肾性贫血,可有效改善贫血状态,提高机体对铁的利用能力。

Objective To investigate the clinical efficacy of roxadustat combined with recombinant human erythropoietin(rhEPO) in the treatment of renal anemia in patients undergoing maintenance hemodialysis(MHD).Methods A total of 108 patients underwent MHD in the hospital from July 2020 to September 2021 were selected and divided into the observation group and the control group according to the propensity score matching method,with 54 cases in each group. The patients in the two groups were given routine treatment for renal anemia,intravenous injection of rhEPO and oral administration of Ferrous Succinate Tablets. On this basis,the patients in the observation group were given oral administration of Roxadustat Capsules.Results After one month and three months of treatment,the red blood cell count(RBC),mean corpuscular hemoglobin concentration(MCHC) in the observation group increased significantly,while the ferritin(FER) level decreased significantly,which were significantly better than those in the control group(P < 0. 05). The levels of hemoglobin(Hb),transferrin saturation(TS),albumin/globulin(A/G) and high-density lipoprotein cholesterol(HDL-C) in the observation group increased significantly after one month and three months of treatment,and those in the observation group were significantly better than those in the control group after three months of treatment(P < 0. 05). The serum albumin(Alb) level in the observation group increased significantly after one month and three months of treatment(P < 0. 05). The serum creatinine(Cr) level in the observation group decreased significantly after three months of treatment(P < 0. 05). The incidence of adverse drug reactions in the observation group was similar to that in the control group(5. 55% vs. 3. 70%,P > 0. 05).Conclusion Roxadustat combined with rhEPO can effectively improve the anemia status and the body′s ability to utilize iron in renal anemia patients underwent MHD.