罗沙司他对比rHuEPO治疗慢性肾脏病腹膜透析患者肾性贫血的疗效及对心脏功能的影响

王保家; 第加美; 谢伟楠; 戴荣; 韩姝; 袁玲

doi:10.16766/j.cnki.issn.1674-4152.004334

罗沙司他对比rHuEPO治疗慢性肾脏病腹膜透析患者肾性贫血的疗效及对心脏功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.004334

王保家¹,
第加美²,
谢伟楠²,
戴荣¹,
韩姝¹,
袁玲^2, ,

1.
蚌埠医科大学研究生院, 安徽蚌埠 233000
2.
安徽理工大学第一附属医院肾内科, 安徽淮南 232000

基金项目:

安徽省卫生健康科研项目 AHWJ2023A10030

详细信息

通讯作者:
袁玲, E-mail: yuanling1218@126.com

中图分类号: R692 R459.5
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- 文章访问数: 8
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- 被引次数: 0
出版历程
- 收稿日期: 2025-01-23
- 网络出版日期: 2026-04-01

The efficacy of roxadustat versus rHuEPO in treating renal anemia and its impact on cardiac function in patients with chronic kidney disease undergoing peritoneal dialysis

1.
Graduate School of Bengbu Medical University, Bengbu, Anhui 233000, China

摘要

摘要: 目的比较罗沙司他与重组人促红素治疗腹膜透析患者肾性贫血的临床疗效及对心脏指标的影响。方法回顾性分析2022年9月—2023年9月安徽理工大学第一附属医院肾病腹透中心收治的接受规律腹膜透析合并肾性贫血的40例患者，其中使用罗沙司他治疗20例(观察组)，使用重组人促红细胞生成素(rHuEPO)治疗20例(对照组)。比较2组患者贫血的疗效及对心脏指标的影响。结果协方差分析调整各指标治疗前水平后，治疗后观察组血红蛋白(Hb)高于对照组，差异有统计学意义[(115.45±12.94)g/L vs. (99.25±13.11)g/L，F=21.233，P＜0.001]。治疗后观察组总胆固醇(TC)、左心房内径(LAD)、室间隔厚度(IVST)水平低于对照组，差异均有统计学意义(P＜0.05)。结论罗沙司他治疗能够更有效地改善患者的贫血状况，同时可以改善患者的铁代谢和脂代谢，对患者心功能的负面影响更小，效果优于rHuEPO。
- 腹膜透析 /
- 肾性贫血 /
- 罗沙司他 /
- 重组人促红素 /
- 心脏功能
Abstract: Objective To compare the clinical efficacy of roxadustat and recombinant human erythropoietin (rHuEPO) in the treatment of renal anemia in peritoneal dialysis patients with chronic kidney disease and its effect on cardiac markers. Methods A retrospective analysis was performed for 40 patients with renal anemia who received regular peritoneal dialysis from September 2022 to September 2023 in the Renal Dialysis Center of the First Affiliated Hospital of Anhui University of Science and Technology, including 20 patients treated with roxadustat (observation group) and 20 patients treated with rHuEPO (control group). The efficacy of anemia and its effect on cardiac indexes were compared between the two groups. Results After adjusting for the pretreatment levels of each index by covariance analysis, the observation group demonstrated significantly higher levels of hemoglobin (Hb) compared to the control group [(115.45±12.94) g/L vs. (99.25±13.11) g/L, F=21.233, P < 0.001] after treatment. The levels of total cholesterol (TC), left anterior posterior diameter (LAD), and interventricular septal thickness (IVST) in the observation group were lower than those in the control group after treatment, the difference was statistically significant (P < 0.05). Conclusion Roxadustat treatment can improve the anemia of patients more effectively, and can improve iron metabolism and lipid metabolism in patients, with less negative impact on cardiac function, and the effect is better than rHuEPO.
- Peritoneal dialysis /
- Renal anemia /
- Roxadustat /
- Recombinant human erythropoietin /
- Cardiac function

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表 1 2组肾性贫血PD患者一般资料比较

Table 1. Comparison of general data between two groups of patients with PD-related anemia

组别	例数	性别(例)		年龄(x±s，岁)	BMI (x±s)	透析龄(x±s，月)	收缩压(x±s，mmHg)	舒张压(x±s，mmHg)	原发病(例)
组别	例数	男性	女性	年龄(x±s，岁)	BMI (x±s)	透析龄(x±s，月)	收缩压(x±s，mmHg)	舒张压(x±s，mmHg)	肾小球肾炎	糖尿病肾病	高血压肾病
观察组	20	11	9	49.10±10.38	23.47±3.92	38.80±5.00	132.35±26.90	90.05±14.89	12	6	2
对照组	20	14	6	48.25±9.86	25.00±4.08	36.90±6.58	143.50±24.91	93.85±14.79	13	5	2
统计量		0.960^a		0.265^b	1.210^b	1.001^b	1.360^b	0.809^b	0.298^a
P值		0.327		0.792	0.234	0.323	0.182	0.423	0.999
注：^a为χ²值，^b为t值；1 mmHg=0.133 kPa。

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表 2 2组肾性贫血PD患者治疗前后贫血指标比较(x±s)

Table 2. Comparison of anemia indicators between two groups of patients with PD-related anemia(x±s)

组别	例数	Hb(g/L)		t值	P值	RBC(×10¹²/L)		t值	P值	Hct(%)		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
观察组	20	82.75±11.10	115.45±12.94	10.983	＜0.001	2.84±0.46	3.88±0.48	9.208	＜0.001	0.23±0.04	0.32±0.09	4.554	＜0.001
对照组	20	82.75±11.10	99.25±13.11	12.278	＜0.001	2.80±0.48	3.75±0.65	8.161	＜0.001	0.24±0.05	0.24±0.08	4.754	＜0.001
统计量		0.620^a	21.233^b			0.259^a	0.518^b			0.197^a	0.128^b
P值		0.539	＜0.001			0.797	0.476			0.845	0.722
注：^a为t值，^b为F值。

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表 3 2组肾性贫血PD患者治疗前后脂代谢指标比较(x±s，mmol/L)

Table 3. Comparison of lipid profiles before and after treatment between two groups of pd patients with renal anemia(x±s, mmol/L)

组别	例数	TC		TG(mmol/L)		HDL		LDL
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	20	3.38±1.08	2.92±0.89^d	1.34(1.03，2.11)	1.15(0.66，2.05)	0.85±0.23	0.86±0.27	1.85(1.27，2.52)	1.46(1.11，2.08)^d
对照组	20	3.81±0.88	4.51±1.65	1.12(0.86，1.54)	1.27(1.07，1.78)^d	0.91±0.29	1.00±0.41	2.28(1.67，2.55)	2.32(1.58，3.11)
统计量		1.367^a	11.471^b	1.163^c	-0.961^c	0.689^a	1.084^b	0.636^c	-3.070^c
P值		0.180	0.002	0.245	0.337	0.495	0.305	0.525	0.002
注：^a为t值，^b为F值，^c为Z值。与同组治疗前比较，^dP＜0.05。

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表 4 2组肾性贫血PD患者治疗前后铁代谢指标比较(x±s)

Table 4. Comparison of iron metabolism indicators between two groups of patients with PD due to renal anemi(x±s)

组别	例数	SI(μmol/L)		Z值	P值	TSAT(%)		Z值	P值	SF(ng/mL)		Z值	P值
组别	例数	治疗前	治疗后	Z值	P值	治疗前	治疗后	Z值	P值	治疗前	治疗后	Z值	P值
观察组	20	9.50(5.36, 13.93)	20.55(14.33, 24.48)	3.398	0.001	14.50(11.25, 27.00)	27.00(23.25，40.25)	2.483	0.013	87.85(55.15，124.45)	116.30(75.30，192.95)	1.060	0.289
对照组	20	9.80(6.82, 14.45)	9.20(5.78, 12.63)	1.008	0.313	20.50(15.25, 27.75)	16.00(10.50，26.75)	0.747	0.455	67.85(54.70，154.78)	36.15(18.13，57.63)	3.875	＜0.001
Z值		0.446	4.410			1.002	2.167			0.379	3.463
P值		0.655	＜0.001			0.316	0.030			0.705	0.001

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表 5 2组肾性贫血PD患者治疗前后心功能指标比较(x±s)

Table 5. Comparison of cardiac function indicators before and after treatment in two groups of patients with renal anemia undergoing PD therapy

组别	例数	LVEF(%)		t值	P值	LAD(mm)		t值	P值	IVST(mm)		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
观察组	20	60.60±8.85	57.10±8.59	2.103	0.049	35.60±6.15	32.40±5.00	5.007	＜0.001	10.20±1.28	10.70±1.62	1.422	0.171
对照组	20	59.15±7.62	59.55±7.85	-0.272	0.788	33.70±4.72	39.35±6.20	5.345	＜0.001	10.65±1.30	12.70±2.07	7.698	＜0.001
统计量		0.555^a	2.728^b			1.096^a	48.742^b			1.099^a	11.951^b
P值		0.582	0.107			0.280	＜0.001			0.279	0.001
注：^a为t值，^b为F值。

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