罗沙司他对维持性血液透析红细胞生成刺激剂低反应性肾性贫血患者血红蛋白达标率、血清叶酸水平的影响

Effect of roxadustat on hemoglobin compliance rate and serum folate level in renal anemia patients with low responsiveness to erythropoietic stimulant receiving maintenance hemodialysis

目的探讨维持性血液透析(maintenance hemodialysis,MHD)红细胞生成刺激剂(erythropoietic stimulant,ESA)低反应性肾性贫血(renal anemia,RA)患者应用罗沙司他的效果,以及对血清血红蛋白(hemoglobin,Hb)达标率、血清叶酸(folic acid,FA)水平的影响。方法选取我院肾内科接受MHD的ESA低反应性RA患者100例,随机分为重组人促红细胞生成素(recombinant human erythropoietin,rhEPO)组(rhEPO治疗)及罗沙司他组(罗沙司他治疗),每组50例。两组均连续治疗12周,比较两组治疗后Hb达标率、血清FA水平。结果治疗4、12周时,罗沙司他组Hb达标率高于rhEPO组(P<0.05)。治疗后,罗沙司他组血清Hb、FA、红细胞压积、红细胞计数、维生素B_(12)水平均高于rhEPO组(P<0.05),血清铁蛋白、转铁蛋白饱和度及血清铁水平均低于rhEPO组(P<0.05)。结论对于接受MHD的ESA低反应性RA患者,罗沙司他疗效显著,能有效改善贫血状况,提高Hb达标率及血清FA水平,改善铁代谢,安全性良好。

Objective To explore the effect of roxadustat on renal anemia(RA)patients with low responsiveness to erythropoietic stimulant(ESA)receiving maintenance hemodialysis(MHD),and its effects on serum hemoglobin(Hb)compliance rate and folic acid(FA)level.Methods A total of 100 RA patients with low responsiveness to ESA receiving MHD in the department of nephrology in our hospital were selected and randomly divided into recombinant human erythropoietin(rhEPO)group and roxadustat group,50 cases in each group.The two groups were treated continuously for 12 weeks,and the Hb compliance rate and serum FA level were compared between the two groups after treatment.Results At 4 and 12 weeks of treatment,the Hb compliance rate in roxadustat group was higher than that in rhEPO group(P<0.05).After treatment,serum Hb,FA,hematocrit,erythrocyte count and vitamin B_(12) levels in roxadustat group were higher than those in rhEPO group(P<0.05),serum ferritin,transferrin saturation and serum iron level in roxadustat group were lower than those in rhEPO group(P<0.05).Conclusion Roxadustat has significant efficacy in RA patients with low responsiveness to ESA receiving MHD,which can effectively improve anemia status,increase Hb compliance rate and serum FA level,improve iron metabolism,and has good safety.