罗沙司他对比重组人促红细胞生成素在维持血液透析患者疗效、对血清微炎症指标及超声心动图相关参数的影响

Effects of roxallistat and recombinant human erythropoietin on efficacy,serum microinflammatory markers and echocardiographic parameters in maintenance hemodialysis patients

目的观察罗沙司他对比重组人促红细胞生成素在维持血液透析患者中的治疗效果,分析其对血清微炎症指标及超声心动图相关参数的影响。方法选取血液透析患者70例,分为2组,服用罗沙司他患者35例,规律皮下注射重组人促红细胞生成素(rHuEPO)患者35例,比较2组患者一般资料;比较2组患者治疗前后血红蛋白、HCT、RBC、同型半胱氨酸、β2微球蛋白、C反应蛋白及血沉。同时采用彩色多普勒超声诊断仪,常规进行彩色多普勒超声心动图检查。所有患者至少随访12个月。结果2组患者基本资料、透析时间、原发病等比较差异无统计学意义(P>0.05)。2组患者纠正肾性贫血疗效比较,2组患者治疗后血红蛋白(Hb)、血细胞比容(HCT)和红细胞计数(RBC)较治疗前明显升高(P<0.05)。2组患者治疗后β2微球蛋白水平和C反应蛋白水平都较治疗前有明显下降(P<0.05);罗沙司他组治疗后β2微球蛋白水平较rHuEPO组治疗后明显减低(P<0.05)。2组患者治疗后心脏彩超中室间隔舒末厚度(IVsd)和左室射血分数(LVEF)较治疗前均有改善(P<0.05)。2组患者治疗前后同型半胱氨酸(Hcy)比较有明显改善(P<0.05)。2组患者治疗后Hb与LVEF值呈正相关(r=0.1928,P<0.05)。结论慢性肾脏病维持血液透析患者使用罗沙司他与rHuEPO相比,能够更好地纠正患者的贫血状况,降低血清微炎症指标,改善慢性炎症状态,且对心血管的相关指标具有一定的保护作用,所以罗沙司他在维持血液透析患者中应用安全性更佳。

Objective To observe the effects of rosalistat on the therapeutic effect,serum inflammatory index and echocardiographic parameters of patients with maintenance hemodialysis.Methods 75 patients were randomly divided into two groups:35 patients in rosalistat group took rosalrestat and 35 patients in recombinant human erythropoietin(rHuEPO)group was received regular subcutaneous injection of recombinant human erythropoietin.The basic parameters of patients between the two groups were compared.Hemoglobin(Hb),hematocrit(HCT),red blood cell count(RBC),homocysteine,β2 microglobulin,C-reactive protein and erythrocyte sedimentation rate were compared between the two groups before and after treatment.At the same time,GE Vivid S6 color doppler ultrasound diagnostic instrument was used to perform routine doppler echocardiography and two-dimensional echocardiography.All patients were followed up for at least 12 months.Results There were no significant differences in the basic data,dialysis time and primary disease between the two groups(P>0.05).The efficacy of correcting renal anemia was observed in two groups of patients.After treatment,Hb,HCT and RBC significantly increased in both groups compared to before treatment(P<0.05).The levels ofβ2 microglobulin and C-reactive protein in both groups were significantly decreased before and after treatment(P<0.05).The level ofβ2 microglobulin in rosallistat group after treatment was significantly lower than that in rHuEPO group(P<0.05).After treatment,both groups of patients showed improvements in ventricular septal end diastolic thickness(IVsd)and left ventricular ejection fraction(LVEF)in cardiac ultrasound compared to before treatment(P<0.05).There was a significant improvement in homocysteine(Hcy)in both groups before and after treatment(P<0.05).Linear correlation analysis showed that hemoglobin(Hb)was positively correlated with left ventricular ejection fraction(LVEF)(r=0.1928,P<0.05).Conclusion Compared with rHuEPO,roxalstat can better correct anemia,reduce serum inflammatory indexes,improve chronic inflammatory status,and have a certain protective effect on cardiovascular related indexes.Therefore,roxalstat is safe in maintenance hemodialysis patients.