罗沙司他对不同透析龄血液透析患者贫血指标及治疗反应的影响

The Effect of Roxadustat on Anemia Indicators and Treatment Response in Hemodialysis Patients with Different Dialysis Vintage

摘要: 目的：罗沙司他(Roxadustat)作为低氧诱导因子脯氨酰羟化酶抑制剂(HIF-PHI)，在纠正维持性透析患者肾性贫血方面显示出良好疗效。本研究旨在探讨透析龄对罗沙司他治疗效果的影响。方法：纳入维持性血液透析并接受罗沙司他治疗的肾性贫血患者65例，按透析龄分为Q1组(0~4年)与Q2组(≥5年)。比较两组患者治疗前后血红蛋白(Hb)、红细胞比容(HCT)等指标的变化，同时记录血清铁(SF)及血脂水平(LDL, TC, TG)等。采用二元Logistic回归分析影响罗沙司他临床效果的独立预测因素。结果：Q1组Hb水平自基线逐月升高，第3个月平均提高至113 g/L，高于Q2组(约106 g/L)；HCT变化趋势亦表现为Q1组改善更显著。二元Logistic回归分析显示，透析龄小于5年为罗沙司他治疗有效的有利预测因素(OR = 0.24, P = 0.04)。两组治疗前后铁代谢与血脂相关指标无显著变化，亦无组间差异。结论：透析龄较短的患者在接受罗沙司他治疗时表现出更好的贫血改善效果。

Abstract: Objective: Roxadustat, as a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), has shown promising efficacy in correcting renal anemia in maintenance dialysis patients. This study aims to investigate the impact of dialysis vintage on the therapeutic effect of Roxadustat. Methods: A total of 65 maintenance hemodialysis patients with renal anemia who received Roxadustat treatment were enrolled. Patients were divided into two groups based on dialysis vintage: the Q1 group (0~4 years) and the Q2 group (≥5 years). Changes in hemoglobin (Hb), hematocrit (HCT), and other anemia-related indices before and after treatment were compared between the two groups. Serum ferritin (SF) and lipid profile (LDL, TC, TG) levels were also recorded. Binary logistic regression was used to analyze independent predictors of the clinical effectiveness of Roxadustat. Results: In the Q1 group, Hb levels increased progressively from baseline, with an average increase to 113 g/L at the third month, significantly higher than in the Q2 group (approximately 106 g/L). The trend in HCT improvement was also more pronounced in the Q1 group. Binary logistic regression analysis revealed that a dialysis vintage of less than 5 years is a favorable predictor of the clinical efficacy of Roxadustat (OR = 0.24, P = 0.04). No significant changes in iron metabolism and lipid-related indices were observed before and after treatment in either group, and no inter-group differences were noted. Conclusion: Patients with a shorter dialysis vintage exhibit better anemia improvement when treated with Roxadustat.