低氧诱导因子脯氨酰羟化酶抑制剂治疗维持性血液透析合并肾性贫血疗效差异因素分析

Analysis of the difference in therapeutic effect of hypoxic-inducible factor prolyl hydroxylase inhibitor in the treatment of renal anemia in maintenance hemodialysis patients

目的 探究低氧诱导因子脯氨酸羟化酶抑制剂——罗沙司他对治疗维持性血液透析患者贫血疗效的差异及相关因素。方法 回顾性分析2019年11月至2020年6月于河北省人民医院规律透析且初次应用罗沙司他的36例患者的临床资料,检测基线及服用罗沙司他2、4、6、8周时血红蛋白(Hb)水平,按用药后各检测点Hb较基线的涨幅情况分为A组(Hb涨幅≥10 g/L)和B组(Hb涨幅<10 g/L或降低);对比两组间基线数据的差异,并探究相关性。结果 服用罗沙司他2周、4周时A组铁蛋白及年龄显著高于B组,差异有统计学意义(P<0.05);服用罗沙司他6周、8周时A组年龄显著高于B组,差异有统计学意义(P<0.05);服用罗沙司他2周(r_(s)=0.359,P=0.031)、4周(r_(s)=0.493,P=0.003)、6周(r_(s)=0.496,P=0.003)、8周(r_(s)=0.417,P=0.018)时的血红蛋白与年龄呈正相关;各检测时间点Hb与基线铁蛋白间无相关性(P>0.05)。结论 年龄及基线铁蛋白水平可能影响维持性血液透析患者初次应用罗沙司他的疗效。

Objective To explore the difference in the efficacy of hypoxic-inducyl factor prolyl hydroxylase inhibitor——Roxadustat——in the treatment of anemia in maintenance hemodialysis patients and the related factors. Methods Clinical data of 36 patients with regular dialysis and initial application of Roxadustat in Hebei General Hospital from November 2019to June 2020 were retrospectively analyzed. Hemoglobin(Hb)levels were tested at baseline and at 2,4,6 and 8 weeks after taking Roxadustat. According to the increase of Hb at each test point compared with the baseline,all patients were divided into Group A(ΔHB≥ 10 g/L)and Group B(ΔHB<10 g/L or decreased). Compare the difference in baseline data between the two groups and explore the correlation. Results The ferritin and age of group A were significantly higher than those of group B after taking Roxadustat for 2 and 4 weeks(P<0.05). The age of group A was significantly higher than that of group B after taking Roxadustat for 6 and 8 weeks(P<0.05). The Hb at the end of 2 nd week(r_(s)=0.359,P=0.031),4 th week(r_(s)=0.493,P=0.003),6 th week(r_(s)=0.496,P=0.003),and 8th week(r_(s)=0.417,P=0.018)of taking Roxadustat was positively correlated with age;there was no correlation between Hb and baseline ferritin(P>0.05)at any test point.Conclusion Age and baseline ferritin levels may affect the efficacy of initial application of Roxadustat in maintenance hemodialysis patients.