涂强 汤小飞 余效辉

*基金项目：景德镇市科技计划项目（20212SFZC011）

【摘要】 目的：观察并比较罗沙司他与重组人促红细胞生成素（rHuEPO）对慢性肾脏病（CKD）5期贫血患者的治疗效果。方法：回顾性选取2021年7月—2022年8月于景德镇市第三人民医院治疗的CKD5期贫血患者60例的临床资料，根据用药方案不同分为罗沙司他组和rHuEPO组，各30例。比较两组临床疗效、血常规、铁代谢情况、炎症指标及不良反应发生率。结果：罗沙司他组治疗总有效率显著高于rHuEPO组（P<0.05）。治疗后，两组红细胞压积（Hct）、血红蛋白（Hb）、血清铁（Fe）较治疗前均升高，且罗沙司他组上述指标均高于rHuEPO组，差异均有统计学意义（P<0.05）。两组治疗前后转铁蛋白饱和度（TSAT）比较，差异均无统计学意义（P>0.05）；治疗后，两组血清铁蛋白（SF）、白细胞介素-6（IL-6）、C反应蛋白（CRP）及肿瘤坏死因子（TNF-α）水平较治疗前均明显下降，且罗沙司他组更低，差异均有统计学意义（P<0.05）。观察期间罗沙司他组不良反应总发生率与rHuEPO组比较，差异无统计学意义（P>0.05）。结论：对于慢性肾脏病5期贫血患者，罗沙司他可显著提高其血红蛋白水平，调节患者铁代谢，减轻炎症反应，降低不良反应率，改善CKD5期贫血的效果显著高于rHuEPO。

【关键词】 罗沙司他 重组人促红细胞生成素 慢性肾脏病 贫血

Comparison of Efficacy of Roxadustat and Recombinant Human Erythropoietin in the Treatment of Anemia of Stage 5 Chronic Kidney Disease/TU Qiang， TANG Xiaofei， YU Xiaohui. //Medical Innovation of China， 2024， 21（13）： -125

[Abstract] Objective： To observe and compare the therapeutic effects of Roxadustat and Recombinant Human Erythropoietin （rHuEPO） in patients with anemia of stage 5 chronic kidney disease （CKD）. Method： Clinical data of 60 patients with anemia of stage 5 CKD treated in the Third People's Hospital of Jingdezhen from July 2021 to August 2022 were selected and divided into Roxadustat group and rHuEPO group according to different medication regimen， with 30 cases in each group. Clinical efficacy， blood routine， iron metabolism， levels of inflammatory factors and incidence of adverse reactions were compared between the two groups. Result： The total effective rate of treatment in the Roxadustat group was significantly higher than that in the rHuEPO group （P<0.05）. After treatment， hematocrit （Hct）， hemoglobin （Hb） and serum Fe in both groups were increased compared to before treatment， and all above indexes in Roxadustat group were higher than those in another group， the differences were statistically significant （P<0.05）. There were no significant differences in transferrin saturation （TSAT） between the two groups before and after treatment （P>0.05）. After treatment， the levels of serum ferritin （SF）， C reactive protein （CRP）， tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in two groups were significantly lower compared with before treatment， and these were lower in Roxadustat group， the differences were statistically significant （P<0.05）. During the observation period， the overall incidence of adverse reactions in Roxadustat group was slightly lower than that in rHuEPO group， the difference was not statistically significant （P>0.05）. Conclusion： For patients with anemia of stage 5 chronic kidney disease， Roxadustat can significantly improve the level of hemoglobin， regulate iron metabolism， reduce inflammatory response， reduce adverse reaction rate， and the effect of improving anemia of stage 5 CKD is significantly higher than that of rHuEPO.

[Key words] Roxadustat Recombinant Human Erythropoietin Chronic kidney disease Anaemia

First-author's address： Department of Nephrology， the Third People's Hospital of Jingdezhen， Jingdezhen 333000， China

doi：10.3969/j.issn.1674-4985.2024.13.028

慢性肾脏病（chronic kidney disease，CKD）在近年来已逐渐成为对人类健康具有严重威胁的全球性卫生问题，疾病知晓率低、患病率高、治疗费用高且具有高致残率[1]。贫血是CKD患者较为常见一种并发症，且随着病情进展、肾功能逐渐下降，患者贫血的发生率随之升高，贫血症状也会更为严重，研究显示，慢性肾脏病患者贫血并发率从CKD1期的8.4%～22.4%到CKD5期可高达53.4%～98.3%[2-3]。对于CKD5期患者贫血发生率极高，导致其预后及生活质量不理想，及时进行临床干预改善肾性贫血对提高患者生活质量、减轻患者家庭经济压力及提高全民健康指数具有重要意义[4]。……