Effect of Jianpi Shengxue Tablet on Iron Metabolism and Nutritional Status in Patients with Renal Anemia:A Prospective,Randomized,Open,Parallel Controlled and Multicenter Clinical Study

Objective This study aimed to analyze the clinical efficacy of the Jianpi Shengxue tablet for treating renal anemia.Methods A total of 200 patients with renal anemia from December 2020 to December 2022 were enrolled and randomly divided into two groups.Patients in the control group were treated with polysaccharide-iron complex,and those in the experimental group were administered Jianpi Shengxue tablet.After 8 weeks of continuous treatment,the therapeutic outcomes regarding anemia were compared between the two groups.Results After treatment,the red blood cell(RBC)count,hematocrit(HCT),reticulocyte percentage(RET),ferritin(SF),serum iron(SI),transferrin saturation(TSAT),and serum albumin(ALB)all increased(P<0.01),and the clinical symptom score and total iron binding capacity decreased(P<0.01)in the experimental group.Moreover,the improvements in RBC,HCT,RET,SF,SI,TAST,ALB,and clinical symptoms(fatigue,anorexia,dull skin complexion,numbness of hands and feet)in the experimental group were significantly greater than those in the control group(P<0.05).The total effective rate for treating renal anemia was significantly higher in the experimental group than in the control group(P<0.01).Conclusion The Jianpi Shengxue tablet demonstrates efficacy in treating renal anemia,leading to significant improvements in the laboratory examination results and clinical symptoms of patients with renal anemia.

Analysis of the Short-Term Curative Effect of Roxadustat in Treating Renal Anemia in Patients with Peritoneal Dialysis

Objective:To analyze the short-term curative effect of roxadustat in the treatment of renal anemia in patients with peritoneal dialysis.Methods:70 patients with peritoneal dialysis renal anemia admitted to the dialysis department of our hospital from March 2021-March 2023 were selected as research objects,divided into a research group and a reference group according to random number drawing method,with each group consisting of 35 cases.The patients in the research group were treated with roxadustat,and those in the reference group were treated with recombinant human erythropoietin.The total efficacy,anemia index,iron metabolism index,and occurrence of adverse reactions were compared between the two groups.Results:The total efficacy of the treatment received in the research group was significantly higher than that in the reference group(P<0.05).In terms of anemia indicators,there was no statistically significant difference between the hemoglobin(Hb),the red blood cell(RBC),and the hematocrit(HCT)of both groups(P>0.05)before treatment.After treatment,the anemia indicators of the patients in the research group were significantly better than those in the reference group,(P<0.05).In terms of iron metabolism,before treatment,there was no significant difference between the total iron-binding capacity(TIBC),the transferrin(TRF),the ferritin(FER),and iron(Fe)of both groups(P>0.05).After treatment,the research group’s iron metabolism indicators were significantly better than those of the reference group(P<0.05).The incidence of adverse reactions in the research group was significantly lower than that in the reference group(P<0.05).Conclusion:The short-term curative effect of roxadustat in the treatment of peritoneal dialysis patients was demonstrated through this study,making it a viable treatment option.

Effect of Sheng Xue Ning Tablets on Renal Anemia in Patients Subject to Maintenance Hemodialysis and Safety Evaluation: A Multi-setting Prospective Randomized Study

This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(MHD).A total of 94 patients undergoing MHD were randomly assigned to an experiment group(receiving oral SXN tablcts,SXN group)and a control group(orally given FS tablets,FS group)and followed up for 12 weeks.Erythropoietin(EPO)was used in both groups.The eficacy was assessed by detecting the subsequent changes in hemoglobin(Hb),serum iron(SI),SF and transferrin saturation(TSAT).At the 12th week,Hb and TSAT levels in both groups were significantly increased compared to those in the screening period(P<0.05).However,no significant difference in Hb and TSAT was found between the two groups.The average weekly EPO dosage used was lower in SXN group than in FS group(P<0.05)at the 10th week and the 12th week.Our study showed that SXN tablets can effectively ameliorate renal anemia and keep iron metabolism stable in MHD patients,and its efficacy is virtually close to that of FS tablets.Meanwhile,SXN tablets can reduce the dosage of EPO and have a good safety profile.

Effect of high flux hemodialysis on renal anemia and soluble transferrin receptor in hemodialysis patients

Objective: To investigate the effect of high throughput hemodialysis on soluble transferrin receptor in hemodialysis patients and the improvement of renal anemia. Methods: 132 patients receiving maintenance hemodialysis in our hospital from July 2017 to July 2019 were selected and divided into control group and observation group according to the random number table method, with 66 cases each. The observation group was treated with high-flux hemodialysis, while the control group was treated with low-flux hemodialysis for 6 months. Compare two groups before and after treatment serum beta 2 microglobulin (beta 2 - MG), serum creatinine (Scr), blood urea nitrogen (BUN) level, anemia related index [red blood cells deposited (HCT), hemoglobin (Hb), reticulocyte percentage (Ret%)], iron metabolism index [serum ferritin (SF), transferrin saturation (TSAT)、Hepcidin(Hepc)], soluble transferrin receptor (sTfR) levels and adverse reactions. Results: the levels of 2-MG, Scr and BUN in the two groups before treatment were compared (P>0.05). After treatment, Scr and BUN levels in the two groups were significantly decreased (P<0.05), but were compared between the two groups (P>0.05). The level of 2-MG in the observation group was lower than that in the control group (P<0.05). Before treatment, sTfR, Hb, HCT level and Ret% of the two groups were compared(P>0.05). After treatment, Hb and HCT levels in the observation group were higher than those in the control group, while Ret% were lower than those in the control group, (P<0.05). Before treatment, the levels of ST、TAST、sTfR and Hepc in the two groups were compared (P>0.05). After treatment, the level of ST and TAST in the observation group was higher than that in the control group, The levels of sTfR and Hepc were lower than the control group (P<0.05). The overall incidence of adverse reactions in the observation group (8.93%) was lower than that in the control group (10.14%), with no significant difference (P>0.05). Conclusion: The high-throughput hemodialysis department significantly improved renal anemia in hemodialysis patients, reduced serum sTfR level, and had fewer adverse reactions and higher safety.

Gene therapy for rat renal anemia with implantation of erythropoietin-transgenic myoblasts

To investigate whether an erythropoietin (EPO) gene-based therapy could serve as an alternative to the repeated injection of rhEPO in treatment to renal anemia, the genetically modified myoblasts of rats, named Myo/ EPO, were implanted through intramuscular injection to model rats with renal anemia. The hemoglobin (Hb) and hematocrit (HCT) of the rats increased from (92. 5±3.0) g/L and 0.29 ±0.04 to the peak values of (103.8 ±5.0) g/L and 0. 32 ±0. 04 respectively 14 d after implantation, and sustained the pre-implantation level for 90 d. Otherwise, the control rats implanted with Myo/X, which carried the parent retroviral vector, gradually became severe in anemia. The PCR detection for hEPO cDNA in the rat muscle adjacent to injection sites indicated that the Myo/EPO cells survived for a long period in the muscle of rats. The results primarily demonstrate that myoblast gene transfer of EPO is effective for the treatment of rat renal anemia.

Prevalence of Severe Anemia (Hb ≤ 5 g/dl) in Non-Dialyzed Chronic Renal Failure Patients in the Nephrology and Hemodialysis Department of Point G University Hospital

Introduction: Chronic renal failure (CRF) is defined as glomerular filtration rate (GFR) less than 60 ml/min/1.73m2 for at least three (3) months. Anemia is one of its most common complications. Anemia increases the risk factor for cardiovascular mortality by 18% per gram of hemoglobin loss. Objectives: To determine the prevalence and characteristics of this severe anemia, to determine the indications for transfusion, the complications related to this anemia, the evolution and the prognosis of these patients. Materials and Methods: This was a descriptive study with retrospective data collection over 18 months (January 1, 2017 to June 30, 2018) that included hospitalized CRF patients. Were included, non-dialyzed chronic renal failure patients with Hb ≤ 5 g/dl hospitalized during the said period. Not included were chronic renal failure patients with an Hb level ≥ 5 g/dl, those followed up and/or hospitalized outside the study period. Results: Among 1176 patients, 26 had severe anemia (Hb level ≤ 5 g/dl) on CRF, a prevalence of 2.21%. The mean age was 40 years ± 32.62 with extremes of 15 and 67 years. Seventeen women and 9 men. The etiology of chronic renal failure (CRF) was hypertensive vascular nephropathy in 50% of cases. CRF was end-stage in 18 patients (69.2%). The mean hemoglobin level was 4.10 g/dl ± 0.64 with extremes of 2 and 5 g/dl. The anemia was microcytic hypochromic in 50% and aregenerative (96.2%). The main symptoms were asthenia in 20 cases (76.9%), dizziness in 20 cases (76.9%), exertional dyspnea in 19 cases (73.1%). Signs of cardiac decompensation (n = 12) were jugular turgor 10 cases (38.5%), hepato-jugular reflux 06 cases (23.1%), mitral insufficiency murmur 06 cases (23.1%). The main complication was left ventricular hypertrophy 17 cases (77.3%). There was no correlation between anemia and sex (p = 0.291), age (p = 0.778), malaria (p = 0.158), etiology of CRF (p = 0.26). The evolution after treatment of anemia was favorable in 19 patients (73.1%), unfavorable in 02 patients (7.7%) and 05 deaths (19.2%). The deaths were of cardiovascular cause: left ventricular insufficiency 04 cases, stroke 01 case. Conclusion: Anemia is frequent in patients with chronic renal failure and remains an important risk factor for cardiovascular disease and poor general condition.

Pharmacodynamic study of recombinant human erythropoietin on a renal anemia model induced by gentamycin in rats

It was demonstrated pathologically that the histological structures of kidneys were impaired after subcutaneous injection of gentamycin for 16 consecutive days in rats. Laboratory parameters showed that serum blood urea nitrogen(BUN) and creatinine (Cr) elevated, while the indices of the erythrogenic line reduced markedly, and erythropoietin (EPO) was not detectable by ELISA. When the rats received recombinant human erythropoietin (rhEPO) for 5 d, the level of EPO in serum went up, and the indices of reticulocyte, red blood cell (RBC),hemoglobin (Hb) and hematocrit (Hct) improved rapidly, of which the response of reticulocyte was most sensitive. The results suggested that the erythrogenic function of the bone marrow in rats was enhanced after the stimulation of rhEPO, and the effect of rhEPO was dose dependent.

罗沙司他与重组人促红素分别联合琥珀酸亚铁治疗血液透析患者肾性贫血疗效的比较

目的 对比分析罗沙司他与重组人促红素(recombinant human erythropoietin,rhEPO)分别联合琥珀酸亚铁治疗维持性血液透析(maintenance hemodialysis,MHD)患者肾性贫血的临床疗效。方法 选择MHD肾性贫血患者120例,按照随机数字表法分为研究组和对照组,每组60例。对照组透析后使用rhEPO联合琥珀酸亚铁治疗,研究组透析后使用罗沙司他联合琥珀酸亚铁治疗。治疗前后,分别检测患者铁代谢水平、贫血指标水平、炎性因子水平及脂代谢水平,比较2组患者的临床疗效,并记录2组患者治疗期间药物不良反应的发生情况。结果治疗后,2组患者的血清铁蛋白(serum ferritin,SF)、转铁蛋白(transferrin,TRF)、转铁蛋白饱和度(transferrin saturation,TSAT)、血细胞比容(hematocrit,Hct)、红细胞计数(red blood cell count,RBC)及血红白蛋白(hemoglobin,Hb)水平均显著提高,铁调素(hepcidin,Hepc)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、总胆固醇(total cholesterol,TC)及低密度脂蛋白(low density lipoprotein,LDL)水平均显著降低,且研究组的效果优于对照组(P<0.05);研究组的治疗总有效率(96.67%,58/60)高于对照组(78.33%,47/60),P<0.05;治疗期间研究组不良反应发生率(3.33%)低于对照组(13.55%),P<0.05。结论 罗沙司他联合琥珀酸亚铁可有效治疗MHD患者的肾性贫血,改善机体铁代谢水平及微炎症,且具有较高的安全性。

罗沙司他治疗腹膜透析贫血疗效及对腹膜转运能力变化的影响

目的观察罗沙司他治疗腹膜透析贫血的疗效及其对腹膜溶质转运能力变化的影响。方法纳入新疆医科大学第五附属医院和新疆维吾尔自治区人民医院2022年1月至2023年1月接受规律腹膜透析贫血的患者100例,随机分为试验组(55例)、对照组(45例),分别使用罗沙司他和促红素注射液治疗。比较治疗前后试验组和对照组的贫血指标、铁代谢指标、炎症指标、腹膜溶质转运能力。结果①治疗8周后,两组患者贫血情况均较治疗前改善(P<0.05)。试验组贫血治疗总有效率略高于对照组(87.04%vs.84.44%),但差异无统计学意义(P>0.05)。②两组患者血清铁蛋白均低于100μg/L,转铁状态蛋白饱和度均>20%,血清铁浓度均处于正常范围,治疗前以及治疗后组间比较差异均无统计学意义(P>0.05)。③治疗前后的C反应蛋白(CRP)中位数均处于正常范围内,但试验组治疗后水平增高,差异有统计学意义(P<0.05)。④两组患者腹膜溶质转运能力中位数水平较治疗前轻度增高(P<0.05),但两组患者腹膜转运能力比较,差异无统计学意义(P>0.05)。结论罗沙司他可以在轻微炎症状态下有效改善腹膜透析患者血红蛋白水平,轻度增加患者腹膜溶质转运能力。罗沙司他与促红素注射液纠正贫血能力和影响腹膜溶质转运能力方面作用相当。

泄浊养血法联合重组人促红素注射液治疗肾虚湿浊型慢性肾脏病3~5期肾性贫血患者的临床观察

[目的]观察泄浊养血法联合重组人促红素注射液对慢性肾脏病(CKD)3~5期肾性贫血患者贫血改善及残余肾功能的干预作用。[方法]选择2020年10月—2021年10月就诊于天津中医药大学第一附属医院的88例CKD 3~5期肾性贫血患者,根据随机数字表法随机分为对照组(44例)和治疗组(44例)。对照组予重组人促红细胞生成素注射液及多糖铁复合物治疗,治疗组在此基础上联合泄浊养血法中药方治疗,连续服用3个月,观察治疗前后两组临床疗效、红细胞计数(RBC)、血红蛋白(Hb)、血清肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(eGFR)、尿微量白蛋白(mALB)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)的变化,症状积分及不良反应发生率。[结果]治疗3个月后,治疗组总有效率为86.36%,对照组为56.82%,治疗组临床疗效优于对照组(P<0.05);症状积分、RBC、Hb、Scr、BUN、mALB均较治疗前改善,且治疗组优于对照组(P<0.05);安全性指标中AST、ALT治疗前后数值变化,差异无统计学意义(P>0.05)。两组病例中均未出现不良反应。[结论]泄浊养血法联合重组人促红细胞生成素注射液治疗可以改善CKD 3~5期非透析肾性贫血患者临床症状,提高临床疗效,延缓肾功能进展,且具有一定的安全性。

罗沙司他治疗肾性贫血不良反应的研究进展

罗沙司他是治疗肾性贫血的一种新型口服药物,主要通过作用于缺氧诱导因子(HIF)通路,促进内源性促红细胞生成素(EPO)的产生及其受体的表达,优化铁的利用等机制,起到升高血红蛋白的作用。然而,罗沙司他在纠正肾性贫血的同时,可能导致深静脉血栓形成、动静脉内瘘血栓形成、高血压、高钾血症等不良反应风险的增加。因此,临床应用罗沙司他时,应加强对患者血管通路、血压、电解质等的监测,及时发现和处理相关不良反应,确保患者的用药安全。

慢性肾功能衰竭腹膜透析患者发生肾性贫血的风险及其预测模型构建

目的探究慢性肾功能衰竭(CRF)腹膜透析患者发生肾性贫血的风险,并建立风险预测模型。方法回顾性分析2018年7月至2021年6月吉安市中心人民医院收治的106例行腹膜透析CRF患者的临床资料,根据肾性贫血发生情况分为肾性贫血组与未发生肾性贫血组,各53例。比较两组肾性贫血相关因子水平[红细胞计数(RBC)、血红蛋白(Hb)、白蛋白(Alb)、C反应蛋白(CRP)、转铁蛋白(TRF)、转铁蛋白饱和度(TSAT)、血清总铁结合力(TIBC)、不饱和铁结合力(UIBC)],Logistic回归分析腹膜透析患者发生肾性贫血的危险因素,建立预测模型并评估其预测效能。结果肾性贫血组RBC、Hb、Alb、CRP、TRF、TSAT、TIBC、UIBC水平均低于未发生肾性贫血组,差异有统计学意义(P<0.05)。Logistic回归分析显示,TRF、TIBC、UIBC是发生肾性贫血的危险因素(P<0.05),ROC曲线显示AUC分别为0.815、0.919和0.826。肾性贫血风险预测模型验证结果显示,74例患者TRF、TIBC、UIBC的准确度为85.1%、86.5%、89.2%。结论TRF、TIBC、UIBC是发生肾性贫血的危险因素,且风险预测模型对肾性贫血发生预测效能较好。

罗沙司他胶囊与红细胞生成刺激剂治疗慢性维持性血液透析合并肾性贫血的临床观察

目的观察口服罗沙司他胶囊与红细胞生成刺激剂(ESAs)对成人慢性维持性血液透析(MHD)合并肾性贫血(RA)患者的临床治疗效果和安全性。方法纳入2023年6月至2024年6月河北唐山982医院和北京京信医院收治的40例MHD合并RA患者,随机分为观察组(n=20)和对照组(n=20)。观察组给予罗沙司他胶囊口服,对照组给予重组人促红素(huEPO)联合静脉铁剂,治疗时长均为12周。比较两组患者总有效率,血液学指标如血红蛋白(Hb)、红细胞计数(RBC)、血细胞比容(HCT),铁代谢指标如血清铁蛋白(SF)、转铁蛋白饱和度(TAST)及不良反应发生率的变化。结果与对照组相比,观察组在治疗12周后的总有效率显著提高(95%比70%,P<0.05);观察组患者的Hb[(104.76±11.73)g/L比(87.58±6.71)g/L]、Hct[(29.37±3.83)%比(25.88±1.96)%]、RBC[(3.36±0.15)×10^(12)L比(2.93±0.24)×10^(12)/L]、SF[(265.45±21.97)Hg/L比(210.59±11.90)Hg/L]、TSAT[(32.66±3.87)%比(28.27±2.27)%]水平均高于对照组,差异有统计学意义(P均<0.05);不良反应发生率无显著差异(15%比20%,P>0.05)。结论口服罗沙司他胶囊较静注huEPO联合静脉铁剂治疗MH合并RA患者疗效更加显著,能有效提高患者的RBC、Hb、HCT、SF、TSAT等指标水平,改善贫血指标,纠正铁代谢紊乱,减少不良反应的发生。

血液红细胞及网织红细胞参数对肾性贫血患者的临床检验价值

目的探究在肾性贫血检验中,血液红细胞及网织红细胞水平的检验意义。方法选取2022年3月至2024年3月期间我院收治的肾性贫血患者45例与非肾性贫血的贫血患者45例纳为研究对象,将肾性贫血患者设为试验组,将非肾性贫血的贫血患者设为对照组,两组患者均接受血液红细胞检测,对比分析两组患者的血液红细胞和网织红细胞参数水平,为临床检验提供医学参考。结果两组患者的平均红细胞血红蛋白浓度(MCHC)、红细胞压积(HCT)、红细胞体积分布宽度变异系数(RDW-CV)、红细胞体积分布宽度标准差(RDW-SD)水平对比差异无统计学意义(P>0.05);试验组患者的平均红细胞血红蛋白量(MCH)和平均红细胞体积(MCV)水平高于对照组,红细胞计数(RBC)水平低于对照组(均P<0.05)。两组患者的血红蛋白(Hb)参数对比差异无统计学意义(P>0.05);试验组患者的低散射网织红细胞百分比(LFR)高于对照组,网织红细胞绝对值(RET#)、网织红细胞百分比(RET%)、未成熟网织红细胞指数(IRF)、中散射网织红细胞百分比(MFR)以及高散射网织红细胞(HFR)均低于对照组(均P<0.05)。结论在肾性贫血患者临床检验中,通过血液红细胞及网织红细胞参数可了解肾性贫血患者病情及贫血程度,为疾病的初期诊断和分析治疗效果提供切实的参考依据,临床检验价值较高。

罗沙司他联合右旋糖酐铁治疗非透析依赖性慢性肾脏病肾性贫血患者的效果

目的:观察罗沙司他联合右旋糖酐铁治疗非透析依赖性慢性肾脏病肾性贫血患者的效果。方法:回顾性分析2020年6月至2023年4月该院收治的198例非透析依赖性慢性肾脏病肾性贫血患者的临床资料,按照治疗方法不同将其分为对照组和观察组各99例。对照组采用右旋糖酐铁治疗,观察组在对照组基础上联合罗沙司他治疗,两组均连续治疗12周。比较两组临床疗效,治疗前后血常规指标[血红蛋白(Hb)、红细胞计数(RBC)]水平、血清铁蛋白(SF)水平、炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,以及不良反应发生率。结果:观察组治疗总有效率为95.96%(95/99),高于对照组的84.85%(84/99),差异有统计学意义(P<0.05);治疗后,观察组Hb、RBC、SF水平均高于对照组,差异有统计学意义(P<0.05);治疗后,观察组CRP、IL-6水平均低于对照组,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:罗沙司他联合右旋糖酐铁治疗非透析依赖性慢性肾脏病肾性贫血患者可提高治疗总有效率、血常规指标水平和SF水平,降低炎性因子水平,效果优于单纯右旋糖酐铁治疗。

罗沙司他治疗慢性肾脏病合并肾性贫血临床价值研究

目的:探讨罗沙司他治疗慢性肾脏病(CKD)合并肾性贫血的临床价值。方法:选取慢性肾脏病合并肾性贫血患者102例,根据治疗方法不同分为观察组(45例)和对照组(57例)。对照组给予重组人促红细胞生成素(rHuEPO)治疗,观察组给予罗沙司他治疗,共治疗12周。比较两组患者疗效、贫血相关指标[血红蛋白(Hb)、血细胞压积(HCT)、红细胞计数(RBC)]、铁代谢指标(铁蛋白、血清铁、总铁结合力)、血脂代谢指标[胆固醇(CHOL)、甘油三酯(TG)、低密度脂蛋白(LDL)]及不良反应发生情况。结果:治疗第12周时,观察组总有效率高于对照组(P<0.05)。治疗第8、12周时,观察组铁蛋白水平低于对照组,血清铁及总铁结合力水平高于对照组(均P<0.05)。治疗第8、12周时,观察组Hb高于对照组,TG及LDL水平低于对照组(均P<0.05)。治疗第12周时,观察组RBC、HCT高于对照组,CHOL低于对照组(均P<0.05)。治疗12周内,两组患者不良反应总发生率比较差异无统计学意义(P<0.05)。结论:对于CKD合并肾性贫血患者,罗沙司他治疗效果较rHuEPO好,能更好地改善贫血相关指标,调节铁代谢及血脂代谢,且安全性较好。

罗沙司他与大剂量rHuEPO治疗腹膜透析肾性贫血患者的效果及安全性

目的:探讨罗沙司他与大剂量重组人促红素(rHuEPO)治疗腹膜透析肾性贫血患者的效果及安全性。方法:选择萍乡市人民医院2022年7—12月收治的60例腹膜透析肾性贫血患者进行本次研究,按照随机数字表法分为两组,各30例。对照组采用大剂量rHuEPO治疗,研究组采用大剂量rHuEPO联合罗沙司他治疗。对比两组疗效和治疗前后肾功能指标[血尿素氮(BUN)、血肌酐(Scr)、β_(2)-微球蛋白(β_(2)-MG)]、血液营养指标[血红蛋白(Hb)、红细胞压积(HCT)、红细胞(RBC)计数]、甲状旁腺激素(PTH)、铁代谢指标[血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)]及不良反应。结果:治疗后,研究组总有效率为90.00%,显著高于对照组的63.33%,差异有统计学意义(P<0.05);治疗后,研究组Hb、HCT、RBC均显著高于对照组,PTH显著低于对照组,差异均有统计学意义(P<0.05);治疗后,研究组SF、TSAT均显著高于对照组(P<0.05);治疗后,研究组BUN、Scr、β_(2)-MG均显著低于对照组,差异均有统计学意义(P<0.05)。结论:罗沙司他联合大剂量rHuEPO治疗可有效改善腹膜透析肾性贫血患者的贫血情况,纠正铁代谢,且不良反应少。

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

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。

罗沙司他联合当归补血汤对AR和NR3C2基因表达的影响

目的基于网络药理学预测罗沙司他联合当归补血汤治疗肾性贫血的作用机制,并进行动物实验验证。方法运用PharmMapper、TCMSP、STRING、GeneCards、OMIM及DAVID数据库进行靶点蛋白及信号通路分析,探讨罗沙司他联合当归补血汤治疗肾性贫血的潜在作用靶点,构建“药物-靶点-疾病”模型,预测可能的生物途径。进行大鼠实验验证关键靶点和作用机制。结果网络药理学研究发现,罗沙司他联合当归补血汤主要通过NR3C2、AR、NR1I3和RUNX1T1共4个共同的蛋白靶点,PI3K-Akt等16条共同信号通路发挥治疗肾性贫血的作用。罗沙司他联合当归补血汤通过上调靶蛋白AR表达、抑制靶蛋白NR3C2的表达来发挥作用。结论罗沙司他联合当归补血汤可通过抑制NR3C2的表达、上调AR的表达来改善机体的炎症及氧化应激,进而发挥治疗肾性贫血的作用。

益气养血方联合促红素治疗糖尿病肾病腹膜透析患者肾性贫血临床观察

目的:探究益气养血方联合促红素治疗糖尿病肾病腹膜透析(PD)患者肾性贫血的临床疗效。方法:选择糖尿病肾病PD合并肾性贫血患者60例,按照随机数字表法分为观察组和对照组各30例,对照组应用常规促红素治疗,观察组在对照组基础上联合益气养血方治疗,评估两组疗效,比较贫血指标、腹膜功能指标水平及不良反应。结果:治疗后,观察组中医证候积分明显低于对照组,且观察组临床疗效(90.00%)明显高于对照组(66.67%)(P<0.05);治疗前两组贫血指标[血红蛋白(Hb)、血细胞比容(Hct)、红细胞计数(RBC)]比较无统计学差异(P>0.05),治疗后观察组Hb、Hct、RBC水平高于对照组(P<0.05);治疗前,两组腹膜功能指标水平[PD血尿素清除指数(Kt/V)、透析液与血液中肌酐的浓度比值(D/Pcr)、PD超滤量(UF)]比较无统计学差异(P>0.05),治疗后,观察组Kt/V、D/Pcr、UF水平高于对照组(P<0.05);观察组不良反应总发生率6.67%,对照组为23.33%,两者比较无统计学差异(P>0.05)。结论:益气养血方联合促红素治疗糖尿病肾病PD患者肾性贫血,可以有效缓解贫血症状,提高治疗疗效及改善贫血相关指标、腹膜功能,且不增加不良反应风险。