罗沙司他治疗病毒性肝炎维持性血液透析合并肾性贫血患者临床疗效及安全性
Clinical efficacy and safety of Roxadustat in the treatment of renal anemia in patients with undergoing maintenance hemodialysis combined with viral hepatitis
陈丽 1张文玉 1常文秀1
作者信息
- 1. 天津市第一中心医院肾内科,天津 300192
- 折叠
摘要
目的 探讨低氧诱导因子脯氨酰羟化酶抑制剂——罗沙司他对病毒性肝炎维持性血液透析合并肾性贫血患者的临床疗效及安全性.方法 选取2022年1月至2022年12月于天津市第一中心医院血液净化中心行维持性血液透析的病毒性肝炎合并肾性贫血且促红细胞生成素治疗效果欠佳的患者30例,改用罗沙司他治疗12个月.比较调整用药前后纠正贫血的总达标率及贫血指标、铁代谢指标和相关理化指标的变化.结果 罗沙司他治疗12个月后,血红蛋白总达标率为93.3％.治疗后患者的贫血相关指标,血红蛋白[109.50(102.25,115.00)g/L比117.50(113.25,124.75)g/L,Z=4.329,P＜0.001]、红细胞比容[(0.30±0.05)％比(0.38±0.06)％,t=3.670,P=0.001]及红细胞计数[(3.16± 0.60)×1012/L比(3.59±0.69)×1012/L,t=5.540,P＜0.001]与治疗前相比均升高,差异有统计学意义.治疗后患者的铁代谢相关指标,血清铁[9.90(8.32,13.18)μmol/L比 13.45(10.80,19.30)μmol/L,Z=3.451,P=0.001]及转铁蛋白饱和度[28.35(21.94,33.06)％比 33.63(26.37,38.95)％,Z=3.211,P=0.001]较前提高;铁蛋白[(274.09±147.51)μg/L 比(184.44±92.21)μg/L,t=-4.197,P＜0.001]及铁调素[(120.48±18.61)ng/L 比(83.42±16.92)ng/L,t=-3.432,P=0.002]较前下降,差异有统计学意义.治疗后相比治疗前患者收缩压、舒张压及相关理化指标未发生明显变化(P＞0.05).结论 罗沙司他能够很好地改善促红细胞生成素治疗效果欠佳的病毒性肝炎维持性血液透析患者的贫血状况,同时可改善患者炎症状态及铁代谢,且安全性较好.
Abstract
Objective To explore the clinical efficacy and safety of hypoxic inducible factor prolyl hydroxylase inhibitors—Roxadustatin patients with viral hepatitis undergoing maintenance hemodialysis and renal anemia.Methods 30 patients with viral hepatitis undergoing maintenance hemodialysis,renal anemia and poor therapeutic effect of erythropoietin from the Blood Purification Center of Tianjin First Central Hospital from January to December in 2022 were selected and treated withRoxadustatfor 12months.The changes of anemia compliance rate,anemia index,iron metabolism index and related physicochemical index before and after adjustedmedication were compared.Results After 12 months of treatment with Roxadustat,the total hemoglobin compliance rate was 93.3％.The anemia related indicators of patients after treatment include hemoglobin[109.50(102.25,115.00)g/L vs.117.50(113.25,124.75)g/L],Z=4.329,P＜0.001;red blood cell specific volume[(0.30±0.05)％vs.(0.38±0.06)％,t=3.670,P=0.001],and red blood cell count[(3.16±0.60)×1012/L vs.(3.59±0.69)×1012/L,t=5.540,P＜0.001]were increased compared to before treatment,and the difference was statistically significant.The iron metabolism related indicators of patients after treatment include serum iron[9.90(8.32,13.18)]μmol/L vs.13.45(10.80,19.30)μmol/L,Z=3.451,P=0.001],and transferrin saturation[28.35(21.94,33.06)％vs.33.63(26.37,38.95)％,Z=3.211,P=0.001]significantly increased compared to before;ferritin[(274.09±147.51)μg/L vs.(184.44±92.21)μg/L,t=-4.197,P＜0.001],and hepcidin[(120.48±18.61)ng/Lvs.(83.42±16.92)ng/L,t=-3.432,P=0.002]decreased compared to before.After treatment,there was no significant change in systolic blood pressure,diastolic blood pressure,and related physicochemical indicators compared to before treatment(P＞0.05).Conclusion Roxadustat can effectively improve the anemia status of maintenance hemodialysis patients with viral hepatitis with poor treatment effect of erythropoietin,and can also improve the inflammation and iron metabolism of patients with good safety.
关键词
罗沙司他/慢性肾脏病/低氧诱导因子脯氨酰羟化酶抑制剂/维持性血液透析/病毒性肝炎/肾性贫血Key words
Roxadustat/chronic kidney disease/hypoxic inducible factor prolyl hydroxylase inhibitors/maintenance hemodialysis/viral hepatitis/renal anemia引用本文复制引用
基金项目
天津市卫健委科技基金面上项目(TJWJ2021MS012)
中国健康促进基金会医疗服务能力建设专项基金之"慧研卓识"期刊战略合作项目()
出版年
2024
国家科技期刊平台
NSTL
万方数据