摘要
目的研究罗沙司他对合并肾性贫血的初始血液透析患者铁代谢指标的影响。方法回顾性分析2021年1月至2022年6月在简阳市人民医院初始进行血液透析且合并肾性贫血的120例患者的临床资料。根据纠正贫血药物不同分为观察组54例与对照组66例,观察组采用罗沙司他联合多糖铁复合物胶囊治疗,对照组采用重组人促红细胞生成素联合多糖铁复合物胶囊治疗,观察周期为3个月。比较两组治疗前后铁代谢指标[血清铁、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)]、贫血指标[血细胞比容(Hct)、红细胞计数(RBC)、血红蛋白]、炎症因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]水平,以及头痛、恶心呕吐、血压升高、腹泻腹痛等不良反应发生情况。结果治疗3个月后,两组血清铁、SF、TSAT、Hct、RBC、血红蛋白水平较治疗前均升高,观察组血清铁、SF、TSAT水平分别为(16.79±6.22)μmol/L、(298.27±115.35)ng/mL、(30.26±15.32)%,较对照组[(12.49±6.41)μmol/L、(214.05±96.92)ng/mL、(24.53±13.70)%]更高,差异均有统计学意义(P<0.05)。治疗3个月后,两组Hct、RBC、血红蛋白水平较治疗前均明显升高,观察组Hct、RBC、血红蛋白水平分别为(39.33±12.17)%、(3.48±0.80)×10^(12)/L、(105.49±23.77)g/L,较对照组[(34.87±10.74)%、(3.21±0.73)×10^(12)/L、(97.54±21.62)g/L]更高,差异均有统计学意义(P<0.05)。治疗3个月后,观察组TNF-α、CRP、IL-6水平较治疗前均下降,差异均有统计学意义(P<0.05),而对照组TNF-α、CRP、IL-6水平与治疗前比较,差异均无统计学意义(P>0.05);观察组TNF-α、CRP、IL-6水平分别为(5.66±2.43)ng/L、(9.63±7.46)mg/L、(18.06±8.25)pg/mL,均较对照组[(10.49±4.61)ng/L、(21.52±5.33)mg/L、(46.51±17.39)pg/mL]明显降低,差异均有统计学意义(P<0.05)。两组患者头痛、恶心呕吐、血压升高、腹泻腹痛等不良反应发生率比较,差异均无统计学意义(P>0
Objective To evaluate the effect of roxadustat on iron metabolism in initial hemodialysis patients with renal anemia.Methods From January 2021 to June 2022,120 patients with renal anemia who initially underwent hemodialysis in Jianyang People's Hospital were retrospectively analyzed.They were divided into observation group with 54 cases and control group with 66 cases according to different anemia correction drugs,the observation group was treated with roxadustat combined with iron polysaccharide complex capsule,and the control group was treated with recombinant human erythropoietin combined with iron polysaccharide complex capsule.The observation period was 3 months.The indices of iron metabolism[serum iron,serum ferritin(SF),transferrin saturation(TSAT)],anemia indicators[haematocrit(Hct),red blood cell count(RBC),hemoglobin],and the levels of inflammatory factors[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),and interleukin-6(IL-6)],as well as adverse reactions such as headaches,nausea and vomiting,elevated blood pressure,diarrhea and abdominal pain before and after treatment were compared between the two groups.Results After treatment,the levels of serum iron,SF,TSAT,Hct,RBC and hemoglobin in the two groups were higher than before treatment,the levels of serum iron,SF and TSAT in the observation group were(16.79±6.22)μmol/L,(298.27±115.35)ng/mL,(30.26±15.32)%,respectively,which were higher than those in the control group[(12.49±6.41)μmol/L,(214.05±96.92)ng/mL,(24.53±13.70)%],the differences were statistically significant(P<0.05).After 3 months of treatment,the levels of Hct,RBC and hemoglobin in the two groups were significantly higher than those before treatmen,the levels of Hct,RBC and hemoglobin in the observation group were(39.33±12.17)%,(3.48±0.80)×10^(12)/L,(105.49±23.77)g/L,respectively,which were higher than those in the control group[(34.87±10.74)%,(3.21±0.73)×10^(12)/L,(97.54±21.62)g/L],the differences were statistically significant(P<0.05).The levels of TNF-α,CRP and IL-
作者
李明鹏
钟晶晶
张凌
王明莉
毛明英
陈德政
LI Ming-peng;ZHONG Jing-jing;ZHANG Ling(Department of Nephrology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China;Department of Nephrology,Jianyang People's Hospital,Jianyang Sichuan 641400,China.;Department of Medicine,Jianyang People's Hospital,Jianyang Sichuan 641400,China)
出处
《临床和实验医学杂志》
2023年第8期817-821,共5页
Journal of Clinical and Experimental Medicine
基金
四川省医院协会青年药师科研专项资金项目(编号:22033)。
