达依泊汀α治疗血液透析贫血对血红蛋白变异情况的观察

The observation of hemoglobin variation in anemic hemodialysis patients treated with darbepoetin alfa

目的探讨达依泊汀α用于治疗血液透析贫血的疗效以及对血红蛋白变异幅度的影响。方法选取合肥金楠肾病专科医院2022年8月—2023年9月的维持性血液透析患者38人,随机分为2组。观察组给予达依泊汀α治疗,对照组给予短效红细胞生成素治疗。研究分为治疗矫正期和治疗维持期,每月定期检测血红蛋白、生化及第0、第5个月的铁代谢情况等指标。比较2组治疗前后血红蛋白水平,分析血红蛋白水平变化趋势,并统计不良事件。结果观察组(n=17)和对照组(n=19)患者治疗前血红蛋白比较差异无统计学意义(t=0.174,P=0.863),治疗结束后2组血红蛋白水平差异无统计学意义(t=0.809,P=0.425)。2组不良事件发生率差异无统计学意义(心力衰竭事件、内瘘闭塞均P=1.000)。治疗矫正期观察组的血红蛋白上升更明显且更稳定(F=3.624,P=0.034)。结论达依泊汀α具有和短效红细胞生成素相当的安全性和治疗效果,并且能够维持血红蛋白水平的稳定增长,降低血红蛋白的变异幅度。

Objective To investigate the efficacy of darbepoetin alfa for the treatment of anemia and its effect on hemoglobin variation in hemodialysis patients.Methods A total of 38 stable hemodialysis patients treated in Hefei Jin'nan Kidney Disease Specialized Hospital from August 2022 to September 2023 were selected and randomly divided into two groups,observation group(n=19;2 dropped out)received darbepoetin alfa treatment,and control group(n=19)received conventional short-acting erythropoiesis stimulating agent treatment.The study consisted of a correction phase and a maintenance phase,with assays of hemoglobin and biochemical indicators monthly,and iron metabolism indicators at 0 and 5th months.Independent samples t-test was used to compare hemoglobin levels before and after treatment between the two groups.Paired t-test was used for before-after self-control comparisons in each group.Repeated measures analysis was performed to examine the trend of hemoglobin change in both groups over time.Chi-square test was used for adverse event analysis.Results There was no significant difference in pretreatment hemoglobin level between the two groups(t=0.174,P=0.863).Post-treatment hemoglobin level also had no significant difference(t=0.809,P=0.425).No significant differences in adverse events(heart failure events,P=1.000;fistula occlusion,P=1.000)were found between the two groups.During the correction phase,the observation group showed a more pronounced and stable hemoglobin increase(F=3.624,P=0.034).Conclusion Darbepoetin alfa has the safety and efficacy comparable to those of short-acting erythropoiesis stimulating agents,and can maintain hemoglobin at a stable increase level with less variability.