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罗沙司他胶囊与重组人促红素治疗肾性贫血的效果及预后比较
作者：李宏彬 梁军 马强
来源：《中国医药导报》2020年第08期
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[摘要] 目的 探討罗沙司他胶囊与重组人促红素（rhEPO）治疗维持性血液透析（MHD）患者肾性贫血的效果及预后。 方法 选取2019年7～10月北京市东城区第一人民医院收治的56例MHD肾性贫血患者为研究对象，依据随机数字表法将其分为对照组与研究组，每组各28例。两组均使用琥珀亚酸铁，对照组在此基础上使用rhEPO进行治疗，研究组则使用罗沙司他胶囊进行治疗，治疗3个月。比较两组治疗前及治疗3个月后贫血指标[红细胞计数（RBC）、血红蛋白（Hb）、血细胞比容（Hct）]、铁代谢指标[血清铁蛋白（SF）、转铁蛋白饱和度（TSAT）、转铁蛋白（TRF）、铁调素（Hepc）]，并记录不良反应发生情况。 结果 两组治疗前RBC、Hb、Hct水平比较，差异无统计学意义（P > 0.05）。治疗3个月后，RBC、Hb、Hct水平高于治疗前，且研究组高于对照组，差异均有统计学意义（均P < 0.05）。两组治疗前SF、TSAT、TRF、Hepc水平比较，差异无统计学意义（P > 0.05）。治疗3个月后，两组SF、TSAT、TRF水平高于治疗前，两组Hepc水平低于治疗前，研究组SF、TSAT、TRF高于对照组，Hepc水平低于对照组，差异均有统计学意义（均P < 0.05）。研究组不良反应发生率低于对照组，差异有统计学意义（P < 0.05）。结论 与rhEPO比较，罗沙司他胶囊治疗MHD肾性贫血效过更佳，可显著纠正贫血症状，增加机体对铁的利用率，安全性较高，有较高的应用价值。
[关键词] 肾性贫血;罗沙司他胶囊;重组人促红素
[中图分类号] R97; ; ; ; ; [文献标识码] A; ; ; ; ; [文章编号] 1673-7210（2020）03（b）-0178-04
[Abstract] Objective To investigate the efficacy and prognosis of Roxadustat Capsules and recombinant human erythropoietin （rhEPO） in the treatment of maintenance hemodialysis （MHD） with renal anemia. Methods A total of 56 cases with MHD renal anemia who admitted to Beijing East District First People′s Hospital from July to October 2019 were selected as the subjects. They were divided into control group and study group by random number table method， with 28 cases in each group. Two groups were treated with Ferrous Succinate Tablets orally， and control group was treated with rhEPO， while study group was treated with Roxadustat Capsules. They were treated for 3 months. Anemia indicators [red blood cell count （RBC）， hemoglobin （Hb），
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hematocrit （Hct）] and iron metabolism indexes [serum ferritin （SF）， transferrin saturation （TSAT）， transferrin （TRF）， hepcidin （Hepc）] were compared between two groups before and after 3 months of treatment， and the adverse reactions were recorded. Results There was no significant difference in the levels of RBC， Hb and Hct between two groups before treatment（P > 0.05）;after 3 months of treatment， the levels of RBC， Hb， Hct were significantly higer than those before treatment， and study group was higher than control group， and the differences were statistically significant（all P < 0.05）. There was no significant difference in the levels of SF， TSAT， TRF and Hepc between two groups before treatment（P > 0.05）. After 3 months of treatment， the levels of SF， TSAT an TRF were significantly higer than those before treatment， the levels of Hepc were lower than those before treatment. The levels of SF， TSAT and TRF in study group were significantly higer than those in control group， the levels of Hepc in study group were lower than those in control group， and the differences were statistically significant（all P < 0.05）. The adverse reactions in study group were lower than those in control group， and the differences were statistically significant（P < 0.05）. Conclusion Compared with rhEPO， Roxadustat Capsules has better efficacy in the treatment of patients with MHD renal anemia， and it can significantly correct the symptoms of anemia， increase the utilization rate of iron in the body， and has higher safety and application value.
[Key words] Renal anemia; Roxadustat Capsules; Recombinant human erythropoietin
肾性贫血是慢性肾脏病（CKD）的常见并发症，主要是因为肾功能受损致使肾脏产生促红细胞生成素（EPO）减少，且随着CKD病情发展程度逐渐加重[1]。研究显示，维持性血液透析（MHD）患者肾性贫血的发病率高达98.2%，严重影响了患者的预后、生存质量，甚至可能诱发心血管疾病，缩短患者预寿命[2]。目前临床主要通过药物治疗纠正MHD肾性贫血症状，其中重组人促红素（rhEPO）、鐵剂为常用药物。近年来研制的新药罗沙司他，作为第二代小分子低氧诱导因子脯氨酰羟化酶（HIF-PHI）抑制剂，可通过调节机体内EPO的合成、改善铁代谢等方式有效改善肾性贫血[3]。本文主要研究罗沙司他胶囊与rhEPO治疗MHD肾性贫血患者的临床效果，现报道如下： 1 资料与方法 1.1 一般资料
选取2019年7～10月北京市东城区第一人民医院（以下简称“我院”）收治的56例MHD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研究组，每组各28例。两组一般资料比较，差异无统计学意义（P > 0.05），具有可比性，见表1。本研究经我院医学伦理委员会批准。
罗沙司他胶囊与重组人促红素治疗肾性贫血的效果及预后比较
