吴雪兵,敖华,王晟,李明
WU Xuebing,AO Hua,WANG Sheng,LI Ming

• 1:国药葛洲坝中心医院肾内科
• 2:国药葛洲坝中心医院检验科

摘要(Abstract)：

目的 探究罗沙司他联合重组人促红细胞生成素(r Hu EPO)对铁蛋白正常和铁过载维持性血液透析(MHD)患者贫血纠正的效果。方法 MHD患者97例，按照入院时血清铁蛋白(SF)水平分为SF过载组(SF≥500 ng/L,n=41)和SF正常组(SF <500 ng/L,n=56)，两组患者均给予罗沙司他联合r Hu EPO治疗4周，治疗结束后评价两组患者临床疗效;于治疗前、治疗4周结束后清晨抽取患者空腹静脉血检测血红蛋白(Hb)水平、红细胞计数(RBC)和血细胞比容(Hct)，检测SF、总铁结合力(TIBC)及铁调素水平，计算转铁蛋白饱和度(TSAT)，检测血清超敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)水平;记录两组患者治疗过程中的不良反应。结果 SF正常组临床总有效率高于SF过载组(P <0.05);治疗后两组患者Hb、RBC、Hct均较治疗前升高，SF正常组改善幅度更大(P <0.05);治疗后两组患者SF水平均较治疗前下降，SF过载组下降更明显(P <0.05)，两组治疗后铁调素、TSAT比较差异无统计学意义(P> 0.05);治疗后两组hs-CRP、IL-6均较治疗前降低(P <0.05)，组间比较差异无统计学意义(P> 0.05);两组患者治疗期间不良反应比较，差异无统计学意义(P>0.05)。结论 罗沙司他联合r Hu EPO治疗能有效改善SF正常和SF过载患者贫血及铁代谢水平，但对SF正常患者的效果更好。
Objective To investigate the effect of roxadustat combined with recombinant human erythropoietin (r HuEPO) on anemia correction in maintenance hemodialysis (MHD) patients with normal ferritin or iron overload.Methods Ninety-seven MHD patients were classified into serum ferritin (SF) overload group (SF≥500 ng/L,n=41) and SF normal group (SF<500 ng/L,n=56)according to baseline SF level.All patients were treated with roxadustat plus r HuEPO for 4 weeks.After the treatment,the clinical efficacy was evaluated in both groups.Fasting venous blood in the morning were collected before treatment and at 4 weeks after treatment.Hemoglobin (Hb),red blood cell count (RBC),and hematocrit (Hct) were measured.SF,total iron binding capacity (TIBC),and hepcidin were detected.Transferrin saturation (TSAT) was calculated.Serum hypersensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were detected.The adverse reactions during the treatment were recorded in both groups.Results The total clinical effective rate of SF overload group was lower than that of normal SF group (P<0.05).After treatment,Hb,RBC,and Hct showed an increase in both groups,and the increase was more remarkable in SF normal group than in SF overload group (P<0.05).After treatment,SF level was decreased in both groups,and the decrease was more obvious in SF overload group than in SF normal group (P<0.05).No significant differences were found in ferritin and TSAT between two groups before and after treatment (P>0.05).After treatment,hs-CRP,and IL-6 were decreased in both groups (P<0.05),but there was no significant difference between two groups (P>0.05).The adverse reaction rate during treatment yielded no statistical difference between two groups (P>0.05).Conclusion Roxabastat combined with r HuEPO treatment is effective in improving anemia and iron metabolism in patients with normal SF and SF overload,but the patients with normal SF may have greater improvement.

关键词(KeyWords)： 罗沙司他;重组人红细胞生成素;维持性血液透析;铁代谢;贫血
roxadustat;recombinant human erythropoietin(rHuEPO);maintenance hemodialysis(MHD);iron metabolism;anemia

Abstract:

Keywords:

基金项目(Foundation): 湖北省卫生计生委科研项目(WJ2019H569)

作者(Author): 吴雪兵,敖华,王晟,李明
WU Xuebing,AO Hua,WANG Sheng,LI Ming

DOI: 10.19367/j.cnki.2096-8388.2023.02.011

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