中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (07): 465-468.doi: 10.3969/j.issn.1671-4091.2021.07.008

• 临床研究 • 上一篇    下一篇

罗沙司他对合并微炎症状态血液透析贫血患者铁代谢的影响研究

刘加强1,2,周忠启1   

  1. 1青岛大学附属第十一临床学院临床医学系肾内科
    2临沂市中心医院肾内科
  • 收稿日期:2021-03-15 修回日期:2021-04-29 出版日期:2021-07-12 发布日期:2021-07-21
  • 通讯作者: 周忠启 zhongqizhou7298@163.com E-mail:258363858@qq.com

The effect of Roxadustat on iron metabolism in hemodialysis patients with microinflammatory state

jia qiangliu   

  1. 1Department of Nephrology, The Eleventh Clinical College Affiliated to Qingdao University, Linyi 276400, China;  2Department of Nephrology, Linyi Central Hospital, Linyi 276400, China
  • Received:2021-03-15 Revised:2021-04-29 Online:2021-07-12 Published:2021-07-21
  • Contact: jia qiangliu E-mail:258363858@qq.com

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摘要： 【摘要】目的探讨罗沙司他治疗合并微炎症状态维持性血液透析患者铁代谢的影响，为临床诊疗提供理论依据。方法选取2020 年5～10 月临沂市中心医院收治的68 例合并微炎症状态的肾性贫血患者为研究对象, 按随机数字表法将其分为对照组与罗沙司他组，每组各34 人。对照组血液透析后使用重组人红细胞生成素(rhEPO)治疗，研究组则使用罗沙司他进行治疗，治疗3 个月。比较2 组治疗前及治疗3 个月后血红蛋白(Hb)、血清铁(SI)、总铁结合力(TIBC)、转铁蛋白饱和度(TSAT)、转铁蛋白、血清铁蛋白(SF)和铁调素(hepcidin)水平。结果罗沙司他治疗后2 月、3 月，罗沙司他组患者Hb 水平高于对照组(t 值分别为4.245、6.433，P 值分别为＜0.001、＜0.001)。治疗后，罗沙司他组患者SI(2 月：t=2.984，P＜0.001；3 月：t=5.433，P＜0.001)、转铁蛋白(2 月：t=3.254，P＜0.001；3 月：t=4.329，P＜0.001)和TIBC(2 月：t=3.854，P＜0.001；3 月：t=5.322，P＜0.001)水平显著高于对照组，而SF(1 月：t=2.245，P=0.030；2月：t=3.851，P＜0.001；3月：t=6.433，P＜0.001)、TSAT(1月：t=2.268，P=0.032；2月：t=3.567，P＜0.001；3 月：t=4.852，P＜0.001)和hepcidin(2 月：t=3.445，P＜0.001；3 月：t=7.343，P＜0.001)水平则低于对照组。结论与rhEPO 治疗比较，罗沙司他胶囊治疗可显著纠正合并微炎症状态维持性血液透析患者贫血，纠正异常的铁代谢状态，增加机体对铁的利用率,为临床诊疗提供了理论依据。

关键词: 肾性贫血, 罗沙司他, 铁代谢, 铁调素

Abstract: 【Abstract】Objective To investigate the effects of Roxadustat on iron metabolism in maintenance hemodialysis (MHD) patients with microinflammation state and renal anemia, in order to provide theoretic bases for the diagnosis and treatment of these patients. Methods A total of 68 MHD patients with microinflammation state and renal anemia admitted to Linyi Central Hospital from May to October, 2020 were enrolled in this study. They were equally divided into control group and study group by random number table method. The control group was treated with recombinant human erythropoietin (rhEPO) after hemodialysis, while the study group was treated with Roxadustat. They were treated for 3 months. Hemoglobin (Hb), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TSAT), transferrin, serum ferritin (SF) and hepcidin were compared before and after 3 months of treatment between the two groups. Results There were no significant differences in age, gender, dialysis age, and the levels of Hb, SI, TIBC, TSAT, transferrin, SF, hepcidin, CRP and PTH between the two groups before treatment (P＞0.05). In the study group after the treatment, Hb, SI, transferrin, and TIBC increased significantly (for Hb, t=4.245, P<0.001 after 2 months, and t=6.433, P<0.001 after 3 months; for SI, t=2.984, P<0.001 after 2 months, and t=5.433, P<0.001 after 3 months;
for transferrin, t=3.254, P<0.001 after 2 months, and t=4.329, P<0.001 after 3 months; for TIBC, t=3.854, P< 0.001 after 2 months, and t=5.322, P<0.001 after 3 months), while SF, TSAT and hepcidin decreased significantly (for SF, t=2.245, P<0.030 after one month, t=3.851, P<0.001 after 2 months, and t=6.433, P<0.001 after 3 months; for TSAT, t=2.268, P<0.032 after one month, t=3.567, P<0.001 after 2 months, and t=4.852, P<0.001 after 3 months; for hepcidin, t=3.445, P<0.001 after 2 months, and t=7.343, P<0.001 after 3 months), as compared with those in the control group. Conclusion Compared with rhEPO, Roxadustat treatment can significantly correct abnormal iron metabolism, increase iron utilization, and improve renal anemia in MHD patients with microinflammation state and renal anemia. This study also provides theoretic bases for the diagnosis and treatment of these patients.

Key words: Renal anemia, Roxadustat, Iron metabolism, Hepcidin

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