罗沙司他重组人促红细胞生成素分别联合多糖铁复合物治疗非透析3~5期慢性肾脏病伴肾性贫血的临床疗效对比

A clinical comparative study of rosastat and rhEPO combined with polysaccharide iron complex in the treatment of non dialysis stage 3~5 CKD with renal anemia

目的探讨罗沙司他、重组人促红细胞生成素(rhEPO)分别联合多糖铁复合物治疗非透析3~5期慢性肾脏病(CKD)伴肾性贫血的临床效果。方法选取2019年6月至2022年6月于浙江省诸暨市中医医院治疗的100例非透析3~5期CKD肾性贫血患者进行前瞻性研究,根据随机数字表法将其分为罗沙司他组(50例)和rhEPO组(50例)2组,2组均给予多糖铁复合物治疗,罗沙司他组在此治疗的基础上联合罗沙司他药物进行治疗,rhEPO组联合rhEPO进行治疗。对比2组的临床疗效、贫血指标水平、铁代谢指标、肾功能以及不良反应发生情况。结果罗沙司他组的治疗总有效率较rhEPO组高(96%、86%)(χ^(2)=5.621,P<0.05);治疗后,罗沙司他组的红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(Hct)较rhEPO组高[(3.64±0.45)×10^(12)/L、(3.04±0.41)×10^(12)/L;(105±9)%、(92±8)%;(36±4)g/L、(30±5)g/L](t=4.561,P<0.05;t=5.231,P<0.05;t=4.267,P<0.05);治疗后,罗沙司他组的转铁蛋白饱和度(TSAT)、铁蛋白(SF)、转铁蛋白(TRF)较rhEPO组高[(34.4±3.2)%、(28.2±3.1)%;(287±17)μg/L、(250±15)μg/L;(2.80±0.32)g/L、(2.42±0.31)g/L](t=5.237,P<0.05;t=4.678,P<0.05;t=4.920,P<0.05);治疗后,2组的血肌酐(Scr)、尿素氮(BUN)比较差异无统计学意义[(17±5)mmol/L、(18±4)mmol/L;(333±57)mmol/L、(340±59)mmol/L](t=5.038,P>0.05;t=5.367,P>0.05);罗沙司他组的不良反应发生率低于rhEPO组(χ^(2)=4.682,P<0.05)。结论罗沙司他较rhEPO联合多糖铁复合物治疗非透析3~5期CKD伴肾性贫血的效果更好,可有效改善患者的贫血及铁代谢,对肾功能无明显影响,不良反应小,安全性较高。

Objective To investigate the clinical effects of rosastat and recombinant human erythropoietin(rhEPO)combined with polysaccharide iron complexes respectively in the treatment of chronic kidney disease(CKD)with renal anemia at stage 3-5 of non dialysis patients.Methods One hundred patients with non-dialysis stage 3-5 CKD renal anemia treated in Zhuji Traditional Chinese Medicine Hospital from June 2019 to June 2022 were selected for prospective study.They were divided into two groups using a random number table method:the rosagliptat group(n=50)and the rhEPO group(n=50).Both groups were treated with polysaccharide iron complexes.On the basis of this treatment,the rosagliptat group was treated with rosagliptat,while the rhEPO group was treated with rhEPO.Compare the clinical efficacy,anemia index levels,iron metabolism indicators,renal function,and incidence of adverse reactions between the two groups.Results The total effective rate of the rosacetam group was higher than that of the rhEPO group(96%vs 86%)(χ^(2)=5.621,P<0.05).After treatment,the red blood cell count(RBC),hemoglobin(Hb),and hematocrit(Hct)of the rosacetam group were higher than those of the rhEPO group[(3.64±0.45)×10^(12)/L vs(3.04±0.41)×10^(12)/L;(105±9)%vs(92±8)%;(36±4)g/L vs(30±5)g/L](t=4.561,P<0.05;t=5.231,P<0.05;t=4.267,P<0.05).After treatment,the transferrin saturation(TSAT),ferritin(SF),and transferrin(TRF)in the rosacetam group were higher than those in the rhEPO group[(34.4±3.2)%vs(28.2±3.1)%;(287±17)μg/L vs(250±15)μg/L;(2.80±0.32)g/L vs(2.42±0.31)g/L](t=5.237,P<0.05;t=4.678,P<0.05;t=4.920,P<0.05).After treatment,there was no significant difference in blood creatinine(Scr)and urea nitrogen(BUN)between the two groups[(17±5)mmol/L vs(18±4)mmol/L;(333±57)mmol/L vs(340±59)mmol/L](t=5.038,P>0.05;t=5.367,P>0.05).The incidence of adverse reactions in the rosacetam group was low in the rhEPO group(χ^(2)=4.682,P<0.05).Conclusion Rosalistat is more effective than rhEPO combined with polysaccharide iron complex in the treatment of non dialysis stage 3~5 CKD with renal anemia,which can effectively improve the anemia index and iron metabolism of patients,and has no significant impact on renal function,with small adverse reactions and high safety.