摘要
目的 观察标准剂量罗沙司他治疗不同慢性肾脏病(CKD)分期非透析肾性贫血患者的疗效及铁代谢变化.方法 回顾性分析2021年6月至2022年10月就诊于中国人民解放军北部战区总医院肾脏病科的非透析CKD3～5期合并肾性贫血且血红蛋白(Hb)未达标的36例患者资料,CKD3、4期为A组(20例),CKD5期为B组(16例),所有患者均以标准起始剂量应用罗沙司他.比较患者使用罗沙司他治疗前和治疗3个月后贫血、生化、铁代谢相关指标变化情况及不良反应.结果 治疗前A组患者Hb、红细胞计数、红细胞压积及转铁蛋白饱和度高于B组,差异有统计学意义(P＜0.05);两组铁蛋白、血清铁及超敏C-反应蛋白差异无统计学意义(P＞0.05).治疗后A组患者Hb达标率为80.0％,B组患者达标率为62.5％,差异无统计学意义(P=0.285);两组患者Hb、红细胞压积、红细胞计数、铁蛋白、转铁蛋白饱和度、血清铁、超敏C反应蛋白差异无统计学意义(P＞0.05).两组患者治疗后与治疗前相比,Hb、红细胞压积、红细胞计数升高,差异有统计学意义(P＜0.05).用药期间,有2例患者出现高钾血症,5例患者出现轻微消化道症状,均可耐受;所有患者未出现心血管不良事件.结论 标准剂量罗沙司他治疗不同CKD分期非透析肾性贫血患者临床疗效良好且安全性较高.
Abstract
Objective To observe the efficacy and changes of iron metabolism of standard dose Roxadustat in the treatment of non-dialysis renal anemia patients with different chronic kidney disease(CKD)stages.Methods The data of 36 non-dialysis CKD3-5 patients with renal anemia and substandard hemoglobin(Hb)were retrospectively analyzed from June 2021 to October 2022 in the Department of Nephrography of the Northern Theater Command Hospital.CKD stage3 and 4 were treated as group A(20 cases),and CKD stage 5 was treated as group B(16 cases).All patients were treated with Roxadustat at the standard starting dose.The changes of anemia,biochemical and iron metabolism indexes and adverse reactions were compared before and 3 months after Roxadustat treatment.Results Before treatment,Hb,red blood cell count,hematocrit and transferrin saturation in group A were higher than those in group B,with statistical significance(P＜0.05).There was no significant difference in ferritin,serum iron and hypersensitive C-reactive protein between the two groups(P＞0.05).After treatment,the Hb compliance rate of group A and group B patients was 80.0％and 62.5％,respectively,with no statistical significance(P=0.285).There were no significant differences in Hb,hematocrit,erythrocyte count,ferritin,transferrin saturation,serum iron and hypersensitive C-reactive protein between 2 groups(P＞0.05).After treatment,Hb,hematocrit and red blood cell count were increased compared with those before treatment,and the differences were statistically significant(P＜0.05).During the treatment period,2 patients had hyperkalemia and 5 patients had mild gastrointestinal symptoms,all of which were tolerable.No adverse cardiovascular events occurred in all patients.Conclusion The standard dose of Roxadustat has good clinical efficacy and high safety in the treatment of non dialysis renal anemia patients with different CKD stages.
基金项目
辽宁省应用基础研究计划项目(2023JHZ/101300078)
国家科技期刊平台
NSTL
万方数据