中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (06): 463-468.doi: 10.3969/j.issn.1671-4091.2025.06.005

• 临床研究 • 上一篇    下一篇

罗沙司他联合铁剂治疗维持性透析患者肾性贫血的效果及对脯氨酸羟化酶2/低氧诱导因子-2α通路的影响

赵建萍   袁 艺   

  1. 635006 达州，1达州市达川区人民医院(达州市第三人民医院)肾病内科
  • 收稿日期:2024-04-19 修回日期:2025-03-21 出版日期:2025-06-12 发布日期:2025-06-12
  • 通讯作者: 赵建萍 E-mail:oapg152@163.com
  • 基金资助:
    2021年四川省医学(青年创新)科研课题项目(S21348)

The efficacy of roxadustat combined with iron therapy in treating renal anemia in maintenance dialysis patients and its impact on the proline hydroxylase 2/hypoxia-inducible factor-2 α pathway

ZHAO Jian-ping, YUAN Yi   

  1. Department of Nephrology, Dachuan District People's Hospital, Dazhou 635006, China
  • Received:2024-04-19 Revised:2025-03-21 Online:2025-06-12 Published:2025-06-12
  • Contact: 635006 达州，1达州市达川区人民医院(达州市第三人民医院)肾病内科 E-mail:oapg152@163.com

摘要： 目的 探讨罗沙司他联合铁剂治疗维持性透析患者肾性贫血的效果及对脯氨酸羟化酶2(proline hydroxylase 2，PHD2)/低氧诱导因子(hypoxia inducible factor，HIF)-2α通路的影响。 方法 选取达州市达川区人民医院2021年6月─2023年6月维持性透析肾性贫血患者111例，按照随机数字表法分为3组。对照1组给予罗沙司他治疗，对照2组给予铁剂治疗，联合组给予罗沙司他联合铁剂治疗。比较3组贫血症状、贫血指标、铁代谢指标、PHD2/HIF-2α通路指标及不良反应。 结果 联合组总有效率高于对照1组(χ2=5.046,P=0.025)、2组(χ2=14.131，P＜0.001)；联合组治疗后面色苍白、头昏、胸闷、记忆力下降评分低于对照1组、2组(F=52.085、81.722、81.208、111.818，均P＜0.001)；联合组治疗后血红蛋白、血细胞比容、红细胞计数、铁蛋白、转铁蛋白、转铁蛋白饱和度、总铁结合力水平高于对照1组、2组(F=44.763、70.279、37.997、64.326、24.704、48.965、52.505，均P＜0.001)，不饱和铁结合力、PHD2、HIF-1α、HIF-2α水平低于对照1组、2组(F=49.801、39.901、62.073、51.449，P＜0.001)。 结论 罗沙司他联合铁剂治疗维持性透析肾性贫血，可通过调节PHD2/HIF-2α通路相关因子，改善患者贫血症状、贫血指标和铁代谢。

关键词: 维持性透析, 肾性贫血, 罗沙司他, 铁剂, 铁代谢, 脯氨酸羟化酶2/低氧诱导因子-2α通路

Abstract: Objective  To investigate the efficacy of roxadustat combined with iron supplements in treating renal anemia in maintenance dialysis patients and its effects on the proline hydroxylase 2 (PHD2)/hypoxia-inducible factor (HIF)-2α pathway.  Methods  A total of 111 patients with renal anemia undergoing maintenance dialysis at Dazhou Dachuan District People’s Hospital from June 2021 to June 2023 were selected and divided into three groups using the random number table method. Control group 1 received roxadustat alone, control group 2 received iron supplements alone, and the combined group received roxadustat plus iron supplements. Anemia symptoms, hematological parameters, iron metabolism indices, PHD2/HIF-2α pathway markers, and adverse reactions were compared across the three groups.  Results  The total effective rate of the combined group was higher than that of the control group 1 (χ2=5.046, P=0.025) and the control group 2 (χ2=14.131, P＜0.001). Post-treatment scores for pallor, dizziness, chest tightness, and memory decline in the combined group were significantly lower than those in control groups 1 and 2 (F=52.085, 81.722, 81.208, 111.818; all P＜0.001). The combined group also showed higher post-treatment hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), ferritin, transferrin, transferrin saturation (TSAT), and total iron-binding capacity (TIBC) compared to both control groups (F=44.763, 70.279, 37.997, 64.326, 24.704, 48.965, 52.505; all  P＜0.001). Conversely, unsaturated iron-binding capacity (UIBC), PHD2, HIF-1α, and HIF-2α levels were significantly lower in the combined group (F=49.801, 39.901, 62.073, 51.449; all P＜0.001). Conclusion  Roxadustat combined with iron therapy effectively improves anemia symptoms, hematological parameters, and iron metabolism in maintenance dialysis patients with renal anemia, potentially through modulation of the PHD2/HIF-2α pathway.

Key words: Maintenance dialysis, Renal anemia, Roxadustat, Iron, Iron metabolism, Proline hydroxylase 2/ hypoxia-inducible factor-2 α pathway

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