摘要
目的观察规律血液透析(HD)与腹膜透析(PD)尿毒症患者应用罗沙司他治疗肾性贫血的临床疗效及安全性差异。方法选取2019年12月至2023年3月尿毒症透析使用罗沙司他治疗肾性贫血的患者102例,按体重选择罗沙司他起始剂量,45~60 kg每次口服100 mg,≥60 kg每次口服120 mg,每周3次给药,连续服用12周,根据血红蛋白(Hb)情况调整药物剂量。患者根据透析方式分为PD组50例,HD组52例;将2组中超敏C反应蛋白(hs-CRP)≥6 mg·L-1设为高hs-CRP亚组,<6 mg·L^(-1)设为正常hs-CRP亚组。观察罗沙司他治疗前后2组患者贫血相关指标、铁代谢、脂代谢变化及不良反应发生情况。结果使用罗沙司他治疗12周后PD组与HD组Hb、红细胞计数(RBC)、血细胞比容(HCT)、血清铁(SI)水平均较治疗前升高(P<0.05),血清铁蛋白(SF)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前下降(P<0.05);PD组治疗后Hb、RBC、HCT、SI、TC、LDL-C水平显著高于HD组(P<0.05);转铁蛋白饱和度(TSAT)、总铁结合力(TIBC)、高密度脂蛋白胆固醇(HDL-C)水平在治疗前后组内、组间比较均无显著差异(P>0.05);TG、SF水平及不良反应发生率组间比较均无显著差异(P>0.05)。治疗12周后2组患者高hs-CRP亚组和正常hs-CRP亚组Hb水平均较治疗前显著升高(P<0.05),亚组间比较无显著差异(P>0.05)。结论罗沙司他可有效改善尿毒症并进行规律HD或PD患者的肾性贫血,且短期安全性良好。与HD患者相比,PD患者的贫血改善更显著。
AIM To observe the difference of clinical efficacy and safety between regular hemodialysis(HD)and peritoneal dialysis(PD)uremic patients treated with roxadustat for renal anemia.METHODS From December 2019 to March 2023,102 renal anemia patients treated with roxadustat for uremic dialysis were selected.The initial dose of roxadustat was chosen based on weight,with 100 mg orally for patients weighing 45 to 60 kg and 120 mg for those weighing≥60 kg.The medication was administered three times a week for 12 consecutive weeks,with dosage adjustments according to hemoglobin(Hb)levels.According to the dialysis method,there were 50 cases in the PD group and 52 cases in the HD group.Within the groups,those with high sensitive C-reactive protein(hs-CRP)≥6 mg·L^(-1)were classified as high hs-CRP subgroup,while those with<6 mg·L^(-1) were considered the normal hs-CRP subgroup.Changes in anemia-related indicators,iron metabolism,lipid metabolism,and adverse reactions before and after roxadustat treatment were observed in both groups.RESULTS After 12 weeks of treatment with roxadustat,the levels of Hb,red blood cell count(RBC),hematocrit(HCT),and serum iron(SI)in the both groups all increased compared with before the treatment(P<0.05),while the levels of serum ferritin(SF),total cholesterol(TC),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)all decreased(P<0.05).After treatment,the levels of Hb,RBC,HCT,SI,TC,and LDL-C in the PD group were significantly higher than those in the HD group(P<0.05).There were no significant differences in transferrin saturation(TSAT),total iron-binding capacity(TIBC),and high-density lipoprotein cholesterol(HDL-C)levels within and between the groups before and after the treatment(P>0.05).There were no significant differences in TG and SF levels and the occurrence of adverse reactions between the two groups(P>0.05).After 12 weeks of treatment,the average Hb level of the high hs-CRP subgroup and normal hs-CRP subgroup of the two groups significantly increased compared with before
作者
曲芹芹
孙治华
邵宁
QU Qin-qin;SUN Zhi-hua;SHAO Ning(Wuhan University of Science and Technology Medical School,Wuhan HUBEI 430065,China;Department of Nephrology,Wuhan University of Science and Technology Tianmen First People's Hospital Postgraduate Training Base,Tianmen HUBEI 431700,China)
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2024年第8期612-617,共6页
Chinese Journal of New Drugs and Clinical Remedies
关键词
罗沙司他
血液透析
腹膜透析
肾性贫血
roxadustat
hemodialysis
peritoneal dialysis
renal anemia
