罗沙司他对维持性腹膜透析患者贫血指标及心功能的影响

Effect of roxadustat on anemia and cardiac function in patients with maintenance peritoneal dialysis

目的探讨罗沙司他对维持性腹膜透析(maintenance peritoneal dialysis,MPD)患者贫血指标及心功能的影响。方法选取2019年1月至2022年12月于我院腹膜透析中心规律随访至少3个月的接受MPD的肾性贫血患者90例,分为对照组及观察组,每组45例。对照组皮下注射促红细胞生成素,观察组口服罗沙司他胶囊,均连续治疗16周。收集并比较两组治疗前后贫血指标[红细胞(red blood cell,RBC)、血红蛋白(hemoglobin,Hb)、血细胞比容(hematocrit,Hct)]、铁代谢指标[转铁蛋白(transferrin,TRF)、总铁结合力(total iron binding capacity,TIBC)、血清铁、血清铁蛋白(serum ferritin,SF)、铁调素(Hepcidin,Hepc)]及心功能指标[脑钠肽(brain natriuretic peptide,BNP)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)]。结果治疗后,两组RBC、Hb及Hct较治疗前明显改善(P<0.05),且观察组高于对照组(P<0.05)。观察组TRF、TIBC、血清铁及SF水平高于对照组(P<0.05),观察组Hepc水平低于对照组(P<0.05)。与对照组相比,观察组BNP水平明显下降(P<0.05);观察组LVEDD、LVESD减少,但差异无统计学意义(P>0.05)。结论罗沙司他可明显改善MPD患者贫血状态,且对心功能有一定改善作用。

Objective To explore the effect of roxadustat on anemia and cardiac function in patients with maintenance peritoneal dialysis(MPD).Methods A total of 90 patients with renal anemia receiving MPD who were regularly followed up for at least 3 months in the Peritoneal Dialysis Center of our hospital from January 2019 to December 2022 were selected and divided into control group and observation group,with 45 cases in each group.The control group was given subcutaneous injection of erythropoietin,and the observation group was given oral roxadustat capsule for 16 weeks.Anemia indexes[red blood cell(RBC),hemoglobin(Hb),hematocrit(Hct)],iron metabolism indexes[transferrin(TRF),total iron binding capacity(TIBC),serum iron,serum ferritin(SF),hepcidin(Hepc)],and cardiac function indexes[brain natriuretic peptide(BNP),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)]were collected and compared.Results After treatment,RBC,Hb and Hct in both groups were significantly improved compared with before treatment(P<0.05),and anemia indexes in observation group were higher than those in the control group(P<0.05).The levels of TRF,TIBC,serum iron and SF in the observation group were higher than those in the control group(P<0.05),and the level of Hepc in the observation group was lower than that in the control group(P<0.05).Compared with control group,BNP level in observation group was significantly decreased(P<0.05).LVEDD and LVESD decreased in the observation group,but the difference was not statistically significant(P>0.05).Conclusion Roxadustat can obviously improve anemia in MPD patients,and has a certain effect on cardiac function.