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罗沙司他或重组人促红素联合静脉用铁剂治疗维持性血液透析合并肾性贫血的疗效与安全性比较
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| 篇名： | 罗沙司他或重组人促红素联合静脉用铁剂治疗维持性血液透析合并肾性贫血的疗效与安全性比较 |
| TITLE： | Efficacy and safety comparison of roxadustat versus recombinant human erythropoietin combined with intravenous iron for renal anemia in patients undergoing maintenance hemodialysis |
| 摘要： | 目的 比较罗沙司他与重组人促红素（rHuEPO）分别联合静脉用铁剂治疗维持性血液透析（MHD）合并肾性贫血（RA）患者的疗效与安全性。方法回顾性纳入2022年1月至2024年6月在西南医科大学附属医院接受MHD治疗且合并RA的152例患者的病历资料，按治疗方案分为观察组（72例）和对照组（80例）。两组患者均接受MHD及静脉用铁剂治疗，观察组加用罗沙司他，对照组加用rHuEPO，疗程均为12周。比较两组患者治疗前后贫血指标、铁代谢指标、炎症因子、心功能参数、生活质量评分以及治疗过程中的不良反应发生情况。结果治疗12周后，两组患者的血红蛋白、红细胞计数、红细胞压积、血清铁、转铁蛋白、总铁结合力、转铁蛋白饱和度、左室射血分数、E/A值、心输出量、健康调查简表评分、肾脏疾病生存质量简表评分均较治疗前显著升高或增多（P＜0.05），铁蛋白、C反应蛋白、白细胞介素6、肿瘤坏死因子α、脑钠肽、氨基末端脑钠肽前体水平均较治疗前显著降低（P＜0.05）；观察组患者上述指标水平的改善程度均显著优于对照组（P＜0.05）。观察组患者不良反应总发生率显著低于对照组（P＜0.05）。结论罗沙司他联合静脉用铁剂治疗在改善MHD合并RA患者的贫血状况、铁代谢情况、炎症状态、心功能及生活质量方面均优于rHuEPO联合静脉用铁剂治疗，且前者安全性更佳。 |
| ABSTRACT： | OBJECTIVE To compare the efficacy and safety of roxadustat versus recombinant human erythropoietin （rHuEPO）， each combined with intravenous iron supplementation， in the treatment of renal anemia （RA） in patients undergoing maintenance hemodialysis （MHD）. METHODS A retrospective analysis was conducted on the medical records of 152 patients diagnosed with RA and receiving MHD at the Affiliated Hospital of Southwest Medical University between January 2022 and June 2024. According to the treatment regimen， patients were divided into observation group （n＝72） and control group （n＝80）. Both groups of patients received MHD and intravenous iron therapy， with the observation group additionally receiving roxadustat and the control group receiving rHuEPO， both for a treatment duration of 12 weeks. Changes in anemia indicators， iron metabolism parameters， inflammatory markers， cardiac function parameters， quality of life scores before and after therapy， and adverse events during treatment were compared between the two groups. RESULTS After 12 weeks of treatment， both groups showed significant increase in hemoglobin， red blood cell count， hematocrit， serum iron， transferrin， total iron binding capacity， transferrin saturation， left ventricular ejection fraction， E/A ratio， cardiac output， 36-Item Short Form Health Survey score， and Kidney Disease Quality of Life Short Form score compared to baseline （P＜0.05）. Conversely， the levels of ferritin， C-reactive protein， interleukin-6， tumor necrosis factor-α， brain natriuretic peptide， and N-terminal pro-B-type natriuretic peptide were significantly reduced （P＜0.05）. The improvements in the observation group were significantly greater than those in the control group （P＜ 0.05）. Moreover， the incidence of adverse events was significantly lower in the observation group compared to the control group （P＜0.05）. CONCLUSIONS Compared to rHuEPO combined with intravenous iron supplementation， roxadustat combined with intravenous iron supplementation is more effective in improving anemia， iron metabolism， inflammatory status， cardiac function， and quality of life in patients with RA undergoing MHD. Additionally， it demonstrates a better safety profile. |
| 期刊： | 2025年第36卷第19期 |
| 作者： | 刘江；丁文飞；文莉 |
| AUTHORS： | LIU Jiang，DING Wenfei，WEN Li |
| 关键字： | 罗沙司他；重组人促红素；维持性血液透析；肾性贫血；终末期肾病 |
| KEYWORDS： | roxadustat； recombinant human erythropoietin； maintenance hemodialysis； renal anemia； end-stage renal disease |
| 阅读数： | 1 次 |
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