罗沙司他对非透析糖尿病肾病贫血患者的疗效观察

Efficacy of Roxadustat for Non-dialysis Diabetic Nephropathy Anemia Patients

目的 观察罗沙司他对非透析糖尿病肾病贫血患者的疗效。方法 回顾性分析2020年1月至2021年4月南京鼓楼医院集团宿迁医院收治的非透析糖尿病肾病贫血患者50例,将使用罗沙司他的24例患者作为观察组,使用重组人促红细胞生成素(EPO)的26例患者作为对照组,给药剂量依据药品说明书,平均随访时间4周。对比两组患者血红蛋白、铁参数的变化以及在不同肾功能分期、C反应蛋白(CRP)状态和血糖控制下罗沙司他对患者的治疗效果。结果 两组患者年龄、身高、体质量、血红蛋白、血脂指标等差异均无统计学意义(P均>0.05)。治疗4周后两组血红蛋白均较基线值升高,观察组均高于对照组(P均<0.05);治疗后两组铁蛋白均较基线值降低,观察组转铁蛋白高于基线值和对照组(P均<0.05);两组慢性肾脏病3~4期(CKD 3~4期)患者的血红蛋白变化值均大于慢性肾脏病5期(CKD 5期)患者(P均<0.05);在高CRP水平下,观察组血红蛋白变化值大于对照组(P均<0.05);不同糖化血红蛋白水平下,两组血红蛋白变化值差异均无统计学意义(P均>0.05)。结论 罗沙司他对非透析糖尿病肾病贫血的疗效优于重组人EPO,且对CKD 3~4期及高CRP水平患者的贫血改善效果更佳。

Objective To observe the effect of roxadustat on non-dialysis diabetic nephropathy anemia patients.Methods A total of 50 non-dialysis patients were enrolled in this study between January 2020 to April 2021,including 24 patients received roxadustat(observation group)and 26 patients received recombinant human erythropoietin(EPO)(control group)from Suqian Hospital of Nanjing Drum Tower Hospital Group.The dosage is according to the instructions.The mean follow-up time was 4 weeks.The mean changes from baseline in hemoglobin and factors related to iron metabolism.The changes of hemoglobin and iron parameters in two groups were observed,and the therapeutic effect of Roxallistat was observed under different renal stage,different CRP status and different blood glucose control status.Results There were no significant differences in age,height,weight,hemoglobin and lipid metabolism indexes between the two groups(P all>0.05).After 4 weeks of treatment,hemoglobin increased from baseline in both groups(P all<0.05).The increase of hemoglobin in observation group was more significant than that in the control group(P all<0.05).In addition,after treatment,the values of ferrictin in both groups were significantly lower than the baseline,and transferrin in the observation group,was significantly higher than the control group(P all<0.05).The changes in hemoglobin was more significant in patients with CKD 3-4 than in patients with CKD 5(P all<0.05).The changes of hemoglobin in observation group under CRP>5 mg·L-1 was more significant than that in EPO group(P all<0.05).Under different HbA1c,there was no significant difference in the change of hemoglobin(P all>0.05).Conclusion Roxadustat is more effective than recombinant human EPO.Patients with high CRP level can achieve better treatment effect of roxadustat than recombinant human EPO.