[1]汪丽丽,孙娴静,张馨怡,等.罗沙司他联合蔗糖铁和促红细胞生成素治疗血液透析患者肾性贫血疗效观察[J].新乡医学院学报,2021,38(9):818-821.[doi:10.7683/xxyxyxb.2021.09.004]
　WANG Lili,SUN Xianjing,ZHANG Xinyi,et al.Clinical effect of roxadustat combined with iron sucrose and erythropoietin in the treatment of renal anemia of hemodialysis patients[J].Journal of Xinxiang Medical University,2021,38(9):818-821.[doi:10.7683/xxyxyxb.2021.09.004]
点击复制

罗沙司他联合蔗糖铁和促红细胞生成素治疗血液透析患者肾性贫血疗效观察
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年9
页码:
818-821
栏目:
临床研究
出版日期:
2021-09-05

文章信息/Info

Title:
Clinical effect of roxadustat combined with iron sucrose and erythropoietin in the treatment of renal anemia of hemodialysis patients
作者:
汪丽丽1; 孙娴静1; 张馨怡2; 张启杰3; 杨宏飞3; 鄢高亮4; 王加英5
（1.东南大学附属中大医院江北院区肾内科，江苏　南京　211500；2.东南大学附属中大医院江北院区内分泌科，江苏南京　211500；3.东南大学附属中大医院江北院区心血管内科，江苏　南京　211500；4.东南大学附属中大医院心血管内科，江苏　南京　211500；5.苏州科技城医院肾内科，江苏　苏州　215000）
Author(s):
WANG Lili1; SUN Xianjing1; ZHANG Xinyi2; ZHANG Qijie3; YANG Hongfei3; YAN Gaoliang4; WANG Jiaying5
（1.Department of Nephrology,Jiangbei District,Zhongda Hospital Affiliated to Southeast University，Nanjing；2.Department of Endocrinology,Jiangbei District,Zhongda Hospital Affiliated to Southeast University，Nanjing；3.Department of Cardiology,Jiangbei District,Zhongda Hospital Affiliated to Southeast University，Nanjing；4.Department of Cardiology,Zhongda Hospital Affiliated to Southeast University，Nanjing 211500；5.Department of Nephrology,Suzhou Science and Technology City Hospital,Suzhou）
关键词:
罗沙司他; 血液透析; 肾性贫血; 氧化应激
Keywords:
roxadustathemodialysisrenal anemiaoxidative stress
分类号:
R556
DOI:
10.7683/xxyxyxb.2021.09.004
文献标志码:
A
摘要:
目的　探讨罗沙司他联合蔗糖铁和促红细胞生成素（EPO）治疗血液透析患者肾性贫血的疗效及对患者氧化应激的影响。方法　选择2019年3月至2020年9月在东南大学附属中大医院江北院区进行血液透析超过3个月且并发肾性贫血的110例患者为研究对象，将患者随机分为对照组和观察组，每组55例。对照组患者在常规血液透析同时给予促红细胞生成素和蔗糖铁治疗，观察组在对照组治疗基础上给予口服罗沙司他100 mg，每周3次，2组患者均治疗12周。治疗前及治疗12周后，采用氰化高铁血红蛋白测定法检测患者血红蛋白（Hb）水平，放射免疫双抗原法检测患者血清铁蛋白（SF），应用普朗全自动血液细胞分析仪检测血细胞比容（Hct），全自动生物化学分析仪测定血清铁含量及总铁结合力并计算转铁蛋白饱和度（TSAT），免疫比浊法检测患者血清中超氧化物歧化酶（SOD）水平，分光光度法检测患者血清中谷胱苷肽过氧化物酶（GSH-Px）及丙二醛（MDA）水平；比较2组患者治疗期间不良反应发生情况。结果　2组患者治疗12周后血清Hb、SF水平及Hct、TSAT均显著高于治疗前（P＜0.05）；治疗12周后，观察组患者血清Hb、SF水平及Hct、TSAT显著高于对照组（P＜0.0.5）。2组患者治疗12周后血清MDA水平显著高于治疗前，血清SOD和GSH-Px水平显著低于治疗前（P＜0.05）；治疗12周后，观察组患者血清MDA水平显著低于对照组，血清SOD和GSH-Px水平显著高于对照组（P＜0.05）。对照组患者出现消化道不适9例，肌肉关节疼痛7例，皮肤瘙痒疼痛5例，不良反应发生率为38.18%（21/55）；观察组患者出现消化道不适2例，肌肉关节疼痛1例，不良反应发生率为5.45%（2/55）；观察组患者不良反应发生率显著低于对照组（χ2=19.850，P＜0.05）。结论　罗沙司他联合蔗糖铁和促红细胞生成素可显著改善血清透析患者肾性贫血，降低患者的氧化应激反应，且不良反应较少。
Abstract:
Objective　To investigate the clinical effect of roxadustat combined with iron sucrose and erythropoietin (EPO) for renal anemia of patients with hemodialysis and the influence on oxidative stress of patients.Methods　A total of 110 patients with renal anemia who received hemodialysis for more than 3 months in Jiangbei District of Zhongda Hospital Affiliated to Southeast University from March 2019 to September 2020 were selected as the study subjects,and they were randomly divided into control group and observation group,with 55 cases in each group.The patients in the control group were treated with erythropoietin and iron sucrose at the same time undergoing routine hemodialysisbased on this,the patients in the observation group took roxadustat 100 mg orally,3 times a weekthe patients in the two groups were treated for 12 weeks.Before treatment and 12 weeks after treatment,the level of hemoglobin (Hb) was measured by cyanated methemoglobin assay,the serum ferric protein (SF) was measured by radioimmunodouble antigen assay,the hematocrit (Hct) was measured by Pran automatic blood cell analyzer,the serum iron content and total iron binding capacity was determined by using biochemical analyzer and the transferrin saturation (TSAT) was calculatedthe serum superoxide dismutase (SOD) level was detected by immunoturbidimetry,and the serum glutathione peroxidase (GSH-PX) and malondialdehyde (MDA) levels were detected by spectrophotometry.The incidence of adverse reactions during treatment was compared between the two groups.Results　The levels of serum Hb,SF and Hct,TSAT of patients after 12 weeks of treatment were significantly higher than those before treatment in the two groups (P＜0.05)after 12 weeks of treatment,the levels of Hb,SF,Hct and TSAT of patients in the observation group were significantly higher than those in the control group (P＜0.0.5).The serum MDA level of patients after 12 weeks of treatment was significantly higher than that before treatment in the two groups (P＜0.05),the serum SOD and GSH-Px levels of patients after 12 weeks of treatment were significantly lower than those before treatment in the two groups(P＜0.05).After 12 weeks of treatment,the serum MDA level of patients in the observation group was significantly lower than that in the control group(P＜0.05),the serum SOD and GSH-Px levels of patients in the observation group were significantly higher than those in the control group(P＜0.05).In the control group,there were 9 cases of gastrointestinal discomfort,7 cases of muscle and joint pain,and 5 cases of skin itching and pain,the incidence of adverse reactions was 38.18% (21/55)in the observation group,there were 2 cases of gastrointestinal discomfort,1 case of muscle and joint pain,the incidence of adverse reactions was 5.45% (2/55).The incidence of adverse reactions of patients in the observation group was significantly lower than that in the control group (χ2=19.850,P＜0.05).Conclusion　Roxadustat combined with iron sucrose and erythropoietin can significantly improve renal anemia of hemodialysis patients,reduce the oxidative stress response of patients,and has fewer adverse reactions.

参考文献/References:

［1］　彭君,秦鹏,邢天柱,等.血液透析联合血液透析滤过治疗对糖尿病肾病患者心脏结构及功能的影响［J］.中国老年学杂志,2019,39(22):5427-5429.
［2］　AKIZAWA T,YAMAGUCHI Y,MAJIKAWA Y,et al.Factors affecting the doses of roxadustat versus darbepoetin alfa for anemia therapy in hemodialysis invalid［J］.Ther Apher Dial,2020,6(5):457-459
［3］　GROENENDAAL-VAN DE MEENT D,KERBUSCH V,KASPERA R,et al.Effect of kidney function and dialysis on the pharmacokinetics and pharmacodynamics of roxadustat,an oral hypoxia-inducible factor prolyl hydroxylase inhibitor［J］.Eur J Drug Metab Pharmacokinet,2021,46(1):141-153.
［4］　REKI C＇ D,KERBUSCH-HERBEN V,N AG ARD M,et al.Pharmacokinetics of roxadustat:a population analysis of 2 855 dialysis- and non-dialysis-dependent patients with chronic kidney disease［J］.Clin Pharmacokinet,2021,60(5):759-773.
［5］　董建华,范文静,吴边,等.罗沙司他治疗血液透析患者红细胞生成素低反应性贫血的疗效观察［J］.肾脏病与透析肾移植杂志,2021,30(3):211-216
［6］　王霜,张益,应士鑫.富马酸亚铁多库酯钠胶囊和多糖铁复合物胶囊对终末期肾病肾性贫血患者氧化应激的影响比较［J］.临床和实验医学杂志,2021,20(4):371-375
［7］　QIE S,JIAO N,DUAN K,et al.The efficacy and safety of roxadustat treatment for anemia in patients with kidney disease:a meta-analysis and systematic review［J］.Int Urol Nephrol,2021,53(5):985-997
［8］　赵娜,郭一丹,赵春霞,等.重组人促红素联合左卡尼汀对老年血液透析患者肾性贫血治疗效果及氧化应激的影响［J］.临床误诊误治,2021,34(4):33-38
［9］　郑可,李雪梅.慢性肾脏病贫血与心血管疾病［J］.中国实用内科杂志,2020,40(11):903-907.
［10］　吴海婷,李航.铁剂在肾性贫血治疗中的临床应用［J］.临床药物治疗杂志,2021,19(8):13-17.
［11］　程红娟,魏芝薇,史慧,等.罗沙司他治疗维持性血液透析患者难治性肾性贫血的疗效观察［J］.实用临床医药杂志,2021,25(14):75-77
［12］　窦海川,郭宏艳,陈燕,等.促红细胞生成素不同给药方式对尿毒症血液透析合并贫血患者炎症及营养状态的影响［J］.中国老年学杂志,2019,39(11):2707-2708.
［13］　丁英,叶君,符晓腾,等.不同补铁方法对血透患者贫血及微炎症的影响［J］.中国实用内科杂志,2014,34(S2):42-44.
［14］　余群青.罗沙司他在慢性肾脏病患者肾性贫血治疗中的效果评价［J］.中外医学研究,2021,19(19):61-64.
［15］　王培培,吴涛.口服罗沙司他对慢性肾脏病并肾性贫血的治疗效果观察［J］.山东医药,2020,60(33):73-75.
［16］　徐伟玲.重组人促红素联合蔗糖铁治疗尿毒症贫血患者的疗效及对氧化应激反应的影响［J］.透析与人工器官,2021,32(2):23-24.
［17］　别昕,张益民,马祖，等.绿茶提取物抗氧化应激治疗对血液透析患者肾性贫血的影响［J］.中国中西医结合肾病杂志,2021,21(7):585-588
［18］　BARGNOUX A S,CRISTOL J P,JAUSSENT I,et al.Vitamin E-coated polysulfone membrane improved red blood cell antioxidant status in hemodialysis patients［J］.J Nephrol,2013,26 (3):556-563．
［19］　王睿,胡洪涛,胡双,等.罗沙司他治疗慢性肾脏病贫血患者的meta 分析［J］.临床肾脏病杂志,2019,19(12):871-876.
［20］　YAN Z,XU G.A novel choice to correct inflammation-induced anemia in CKD:oral hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat［J］.Front Med(Lansanne),2020,7:393.
［21］　李艳.蔗糖铁注射液治疗血液透析患者肾性贫血的临床疗效观察［J］.中国现代药物应用，2021,15(13):190-192.
［22］　CHEN N,HAO C,PENG X,et al.Roxadustat for anemia in patients with kidney disease not receiving dialysis［J］.N Engl J Med,2019,381(11):1001-1010
［23］　方玲,常晓燕,汪燕燕,等.罗沙司他治疗肾脏透析患者贫血有效性和安全性的meta分析［J］.中国医院药学杂志,2020,40(23):2435-2439.
［24］　史亚男,胡志娟,赵鹏,等.低氧诱导因子-脯氨酰羟化酶抑制剂治疗血液透析患者肾性贫血的疗效和安全性分析［J］.中国实用内科杂志,2020,40(11):920-925.

相似文献/References:

[1]周长菊,章旭,曹娟,等.维持性血液透析患者采用不同血液净化方式心脏瓣膜钙化高危因素分析[J].新乡医学院学报,2012,29(04):000.
[2]任　伟,王玉梅,陈永健.老年糖尿病肾病患者血液透析相关肺炎危险因素分析[J].新乡医学院学报,2021,38(1):076.[doi:10.7683/xxyxyxb.2021.01.017]
　REN Wei,WANG Yumei,CHEN Yongjian.Analysis of the risk factors of hemodialysis associated pneumonia in elderly patients with diabetic nephropathy[J].Journal of Xinxiang Medical University,2021,38(9):076.[doi:10.7683/xxyxyxb.2021.01.017]
[3]周莉莉,刘　佳,张晓艳.罗沙司他治疗肾性贫血的作用机制及临床研究进展[J].新乡医学院学报,2021,38(5):488.[doi:10.7683/xxyxyxb.2021.05.020]
[4]袁小强,张献朝,赵丽萍.西那卡塞和骨化三醇联合治疗糖尿病肾病血液透析患者继发性甲状旁腺功能亢进症疗效观察[J].新乡医学院学报,2022,39(2):131.[doi:10.7683/xxyxyxb.2022.02.006]
　YUAN Xiaoqiang,ZHANG Xianchao,ZHAO Liping.Effect of cinacalcet and calcitriol in the treatment of secondary hyperparathyroidism in diabetic nephropathy patients undergoing hemodialysis[J].Journal of Xinxiang Medical University,2022,39(9):131.[doi:10.7683/xxyxyxb.2022.02.006]
[5]鲁　冰,任东升,陶雅非,等.维持性血液透析与持续不卧床腹膜透析对终末期肾病患者钙磷代谢及氧化应激的影响比较[J].新乡医学院学报,2022,39(9):833.[doi:10.7683/xxyxyxb.2022.09.007]
　LU Bing,REN Dongsheng,TAO Yafei,et al.Comparison of the effect of maintenance hemodialysis and continuous ambulatory peritoneal dialysis on calcium and phosphorus metabolism and oxidative stress in patients with end-stage renal disease[J].Journal of Xinxiang Medical University,2022,39(9):833.[doi:10.7683/xxyxyxb.2022.09.007]
[6]王岩,张爱霞,王紫晖,等.碱性成纤维细胞生长因子、血清和糖皮质激素诱导的蛋白激酶3表达与血液透析患者动静脉内瘘失功的关系[J].新乡医学院学报,2023,40(9):851.[doi:10.7683/xxyxyxb.2023.09.009]
　WANG Yan,ZHANG Aixia,WANG Zihui,et al.Relationship between the expression of basic fibroblast growth factor,serum and glucocorticoid-induced protein kinase 3 and the dysfunction of arteriovenous fistula in patients undergoing hemodialysis[J].Journal of Xinxiang Medical University,2023,40(9):851.[doi:10.7683/xxyxyxb.2023.09.009]

更新日期/Last Update: 2021-09-05