罗沙司他联合血液透析对尿毒症患者的疗效及对claudin-1、β2-MG水平的影响

Effect of roxadustat combined with hemodialysis on the levels of claudin-1 andβ2-MG in uremia patients

目的分析罗沙司他联合血液透析对尿毒症患者的疗效及对紧密连接跨膜蛋白(claudin-1)、β2-微球蛋白(β2-MG)水平的影响。方法选取2019年6月至2020年6月在本院治疗的156例尿毒症患者,随机分为对照组和观察组,每组各78例。对照组采用血液透析进行治疗,观察组在对照组的基础上给予罗沙司他。对比两组治疗前后的尿素氮(BUN)、β2-MG、甲状旁腺激素(PTH)、白细胞介素-1β(IL-1β)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平,紧密连接蛋白(ZO-1)、claudin-1、闭锁蛋白的相对表达量以及临床疗效和治疗过程中出现的并发症等。结果治疗前,两组的BUN、PTH、β2-MG、IL-1β、CRP、TNF-α、ZO-1、claudin-1、闭锁蛋白水平比较,差异均无统计学意义(均P>0.05);与治疗前比较,治疗后两组的BUN、PTH、β2-MG、IL-1β、CRP、TNF-α水平降低,ZO-1、claudin-1、闭锁蛋白水平升高,且观察组的BUN、PTH、β2-MG、IL-1β、CRP、TNF-α水平低于对照组,ZO-1、claudin-1、闭锁蛋白水平高于对照组,差异均有统计学意义(均P<0.05)。观察组的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组的并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论罗沙司他联合血液透析治疗尿毒症效果较好,可改善患者的残余肾功能,减轻患者炎症反应,有效减少患者并发症的发生。

Objective To analyze the effect of roxadustat combined with hemodialysis on the levels of tightly linked transmembrane proteins(claudin-1)and beta-2-microglobulin(β2-MG)in uremia patients.Methods A total of 156 patients with uremia treated in our hospital from June 2019 to June 2020 were randomly divided into control group(78 cases)and observation group(78 cases),the control group was treated with hemodialysis,and the observation group was treated with roxadustat on the basis of the control group.Both groups were treated for 4 months,levels of Usea nitrogen(BUN),β2-MG,plasma parathyroid hormone(PTH),leukin 1(IL-1β),serum C-response protein(CRP),and tumor necrosis factorα(TNF-α)were compared between the two groups before and after treatment.The relative expression of tightly linked protein(ZO-1),claudin-1,closed-lock protein,occludin were compared between the two groups before and after treatment.The clinical efficacy,complications during treatment were analyzed.Results Before treatment,there were no significant differences in BUN,PTH,β2-MG,IL-1β,CRP,TNF-α,ZO-1,claudin-1 and occludin levels between the two groups(all P>0.05).Compared with before treatment,BUN,PTH,β2-MG,IL-1β,CRP,TNF-αlevels decreased after treatment,ZO-1,claudin-1,occludin levels increased,and BUN,PTH,β2-MG,IL-1β,CRP,TNF-αlevels in observation group were lower than those in control group.ZO-1,claudin-1 and occludin levels were higher than those of control group,and the differences were statistically significant(all P<0.05).The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusions Roxadustat combined with hemodialysis is effective in the treatment of uremia,which can improve the residual renal function,reduce the inflammatory reaction and effectively reduce the occurrence of complications.