重组人促红细胞生长素联合维生素D治疗对腹膜透析肾性贫血患者的影响

Effect of Recombinant Human Erythropoietin Combined with Vitamin D on Renal Anemia Patients Undergoing Peritoneal Dialysis

目的:研究重组人促红细胞生长素联合维生素D治疗腹膜透析肾性贫血患者的影响。方法:选取2022年1月—2023年6月于晋江市医院进行诊治的120例腹膜透析肾性贫血患者,按照随机数表法分为观察组[活性维生素D(骨化三醇)+重组人促红细胞生长素注射治疗]和对照组(应用重组人促红细胞生长素注射治疗),各60例。比较两组治疗前后血细胞情况[血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(HCT)]、铁代谢指标[血清铁调素、血清铁(SI)、血清铁蛋白(SF)]、甲状腺激素水平[血游离三碘甲状腺原氨酸(FT_(3))、血游离甲状腺素(FT_(4))、促甲状腺素(TSH)、全段甲状旁腺激素(PTH)]及不良反应发生情况。结果:治疗后,两组Hb、RBC和HCT水平均高于治疗前,且观察组Hb和RBC水平高于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清铁调素、SF低于治疗前,SI高于治疗前,且观察组血清铁调素、SF低于对照组,SI高于对照组,差异有统计学意义(P<0.05)。治疗后,两组TSH、FT_(3)、FT_(4)高于治疗前,PTH低于治疗前,且观察组TSH、FT_(4)高于对照组,PTH低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(χ^(2)=1.345,P=0.246)。结论:重组人促红细胞生长素联合维生素D治疗可显著改善腹膜透析肾性贫血患者血细胞指标,调节铁代谢及甲状腺激素水平,且未见明显不良反应。

Objective:To study the effect of Recombinant Human Erythropoietin combined with vitamin D on peritoneal dialysis patients with renal anemia.Method:A total of 120 patients with peritoneal dialysis renal anemia treated in Jinjiang Hospital from January 2022 to June 2023 were selected and divided into observation group[active vitamin D(Calcitriol)+Recombinant Human Erythropoietin injection treatment]and control group(Recombinant Human Erythropoietin injection treatment)by random number table method,with 60 cases in each group.Blood cell conditions[hemoglobin(Hb),red blood cell count(RBC),hematocrit(HCT)],iron metabolism indexes[serum hepcidin,serum iron(SI),serum ferritin(SF)],thyroid hormone levels[serum free triiodothyronine(FT_(3)),serum free thyroxine(FT_(4)),thyrotropin(TSH),total parathyroid hormone(PTH)]before and after treatment and the occurrence of adverse reactions between the two groups were compared.Result:After treatment,Hb,RBC and HCT levels in two groups were higher than those before treatment,and Hb and RBC levels in observation group were higher than those in control group,the differences were statistically significant(P<0.05).After treatment,serum hepcidin and SF were lower than those before treatment,SI was higher than that before treatment,and serum hepcidin and SF in observation group were lower than those in control group,SI was higher than that in control group,the differences were statistically significant(P<0.05).After treatment,TSH,FT_(3) and FT_(4) of the two groups were higher than those before treatment,and PTH was lower than that before treatment,and TSH and FT_(4) of the observation group were higher than those of the control group,and PTH was lower than that of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(χ^(2)=1.345,P=0.246).Conclusion:Recombinant Human Erythropoietin combined with vitamin D can significantly improve blood cell indexes,regulate iron metabolism and thyroid hormone levels in patients with peritoneal dialysis renal anemia,and no obvious adverse reactions were observed.