摘要
目的 观察尿毒症伴贫血患者动静脉内瘘术后采用小剂量罗沙司他治疗的有效性及安全性。方法 收集48例动静脉内瘘术后的尿毒症伴贫血患者为研究对象,随机分为治疗组(23例)和对照组(25例)。治疗组给予小剂量罗沙司他治疗,对照组给予促红细胞生成素(EPO)治疗。比较两组患者不同随访阶段(基线期、术后3个月、术后6个月、术后9个月、术后12个月)血红蛋白、血压(收缩压、舒张压)、血清铁、铁蛋白(SF)、转铁蛋白饱和度(TSAT)、C反应蛋白(CRP)、全段甲状旁腺激素(iPTH)、电解质(钾离子、钠离子、氯离子、钙离子、磷酸盐)变化情况,不良反应发生情况。结果 两组基线期血红蛋白、术后平均血红蛋白、基线期达标率、术后平均达标率比较均无统计学差异(P>0.05)。治疗组术后12个月血红蛋白(105.87±19.48)g/L高于基线期的(94.70±16.49)g/L,有显著性差异(t=2.099, P=0.042<0.05),术后3、6、9个月血红蛋白与基线期比较均无统计学差异(P>0.05)。对照组基线期血红蛋白与术后3、6、9、12个月比较均无统计学差异(P>0.05)。两组术后3个月、术后6个月、术后9个月、术后12个月血红蛋白比较均无统计学差异(P>0.05)。两组基线期、术后3个月、术后6个月、术后9个月、术后12个月收缩压、舒张压比较,无统计学差异(P>0.05)。两组不良反应发生率比较无统计学差异(P>0.05)。两组基线期、术后3个月、术后6个月、术后9个月、术后12个月血清铁比较,无统计学差异(P>0.05)。两组基线期、术后3个月、术后6个月、术后9个月SF、TSAT比较,无统计学差异(P>0.05);治疗组术后12个月SF(255.83±80.79)μg/L、TSAT(27.59±7.35)%高于对照组的(207.96±66.02)μg/L、(23.59±6.13)%,有显著性差异(P<0.05)。两组基线期、术后3个月、术后6个月、术后9个月、术后12个月CRP、iPTH、钾离子、钠离子、氯离子、钙离子、磷酸盐比较,无统计学差异(P>0.05)。结论 尿毒症伴贫血患者动静脉内瘘术后采用小剂量罗沙司他治疗的效果优于EPO,安全性良好。
Objective To observe the efficacy and safety of low-dose roxadustat in the treatment of uremic patients with anemia after arteriovenous fistula surgery.Methods 48 cases of uremic patients with anemia after arteriovenous fistula surgery were studied and randomly divided into a treatment group(23 cases)and a control group(25 cases).The treatment group was treated with low-dose roxadustat,while the control group was treated with erythropoietin(EPO).Patients in both groups were compared in terms of hemoglobin,blood pressure(systolic blood pressure and diastolic blood pressure),serum iron,serum ferritin(SF),transferrin saturation(TSAT),C-reactive protein(CRP),intact parathyroid hormone(iPTH)and electrolyte(potassium ions,sodium ions,chloride ions,calcium ions,phosphate)changes at different follow-up stages(baseline,3 months,6 months,9 months and 12 months after surgery),and occurrence of adverse reactions.Results There was no statistically significant difference between the two groups when comparing the baseline hemoglobin,postoperative mean hemoglobin,baseline compliance rate,and postoperative mean compliance rate(P>0.05).In the treatment group,the hemoglobin of(105.87±19.48)g/L at 12 months after surgery was higher than(94.70±16.49)g/L at baseline,and there was a significant difference(t=2.099,P=0.042<0.05);there was no statistically significant difference in the comparison of hemoglobin at 3,6,and 9 months after surgery compared with that at baseline(P>0.05).In the control group,there was no statistically significant difference in hemoglobin at baseline compared with 3,6,9,and 12 months after surgery(P>0.05).There was no statistically significant difference in the comparison of hemoglobin at 3,6,9,and 12 months after surgery between the two groups(P>0.05).There was no statistical difference between the two groups in comparison of systolic blood pressure and diastolic blood pressure at baseline,3 months after surgery,6 months after surgery,9 months after surgery,and 12 months after surgery(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no significant difference in serum iron between the two groups at baseline,3 months,6 months,9 months and 12 months after surgery(P>0.05).There were no significant differences in SF and TSAT between the two groups at baseline,3 months,6 months and 9 months after surgery(P>0.05).At 12 months after surgery,the treatment group had SF of(255.83±80.79)μg/L and TSAT of(27.59±7.35)%,which were higher than(207.96±66.02)μg/L and(23.59±6.13)%in the control group,and there were significant differences(P<0.05).There was no significant difference in CRP,iPTH,potassium ion,sodium ion,chloride ion,calcium ion and phosphate between the two groups at baseline,3 months after surgery,6 months after surgery,9 months after surgery and 12 months after surgery(P>0.05).Conclusion The effect of low-dose roxadustat on uremic patients with anemia after arteriovenous fistula surgery is better than EPO,and it has high safety.
作者
李政
刘颖
黄琴
张筱文
蔡允平
LI Zheng;LIU Ying;HUANG Qin(Department of Nephrology,Pulandian District Central Hospital,Dalian 116200,China)
出处
《中国实用医药》
2024年第19期1-7,共7页
China Practical Medicine
