罗沙司他对维持性血液透析肾性贫血患者的影响

Effect of Roxadustat on Maintenance Hemodialysis Patients with Renal Anemia

目的:分析罗沙司他对维持性血液透析(MHD)肾性贫血患者的影响。方法:前瞻性选取2022年1月—2023年12月济南威高肾科医院收治的112例MHD肾性贫血患者。根据随机数表法将其分为对照组和观察组,各56例。对照组应用重组人促红素注射液,观察组应用罗沙司他。比较两组临床疗效,治疗前后贫血指标、铁代谢指标、炎症因子及不良反应。结果:观察组总有效率为92.86%,高于对照组的78.57%,差异有统计学意义(P<0.05)。治疗后,两组血红蛋白(Hb)、血细胞比容(Hct)、铁蛋白(SF)、转铁蛋白饱和度(TSAT)水平均升高,观察组Hb、Hct、SF、TAST水平均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均降低,观察组IL-6、hs-CRP、TNF-α水平均明显低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:罗沙司他能够减轻MHD肾性贫血患者的炎症反应,调节铁代谢,增加内源性铁利用,快速有效地提高贫血治疗效果,且具有一定安全性。

Objective:To analyze the effect of Roxadustat on maintenance hemodialysis(MHD)patients with renal anemia.Method:A total of 112 patients with MHD renal anemia admitted to Jinan Weigao Nephrology Hospital from January 2022 to December 2023 were prospectively selected.They were divided into control group and observation group according to random number table method,with 56 cases in each group.The control group was treated with Recombinant Human Erythropoietin Injection,and the observation group was treated with Roxadustat.The clinical efficacy,anemia indexes,iron metabolism indexes,inflammatory factors before and after treatment and adverse reactions were compared between the two groups.Result:The total effective rate of observation group was 92.86%,which was higher than 78.57%of control group,the difference was statistically significant(P<0.05).After treatment,the levels of hemoglobin(Hb),hematocrit(Hct),ferritin(SF)and transferrin saturation(TSAT)were increased in both groups,and the levels of Hb,Hct,SF and TAST in observation group were higher than those in control group,the differences were statistically significant(P<0.05).After treatment,the levels of interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in both groups were decreased,and the levels of IL-6,hs-CRP and TNF-αin observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Roxadustat can reduce the inflammatory response of MHD patients with renal anemia,regulate iron metabolism,increase the utilization of endogenous iron,quickly and effectively improve the effect of anemia treatment,and has a certain safety.