| 刘 阳,李 雷,汤 伟,孙 东,程 坤.血清25 (OH)D、NGAL、Hepcidin与罗沙司他胶囊治疗维持性血液透析患者肾性贫血临床疗效的关系研究[J].,2024,(8):1554-1559 |
| 血清25 (OH)D、NGAL、Hepcidin与罗沙司他胶囊治疗维持性血液透析患者肾性贫血临床疗效的关系研究 |
| Study on the Clinical Efficacy of Relationship between Serum 25(OH)D, NGAL, Hepcidin and Roxadustat Capsules in the Treatment of Renal Anemia in Maintenance Hemodialysis Patients |
| 投稿时间：2023-09-19 修订日期：2023-10-15 |
| DOI：10.13241/j.cnki.pmb.2024.08.030 |
| 中文关键词: 维持性血液透析 肾性贫血 罗沙司他胶囊 25 (OH)D NGAL Hepcidin 临床疗效 |
| 英文关键词: Maintenance hemodialysis Renal anemia Roxadustat capsules 25 (OH)D NGAL Hepcidin Clinical efficacy |
| 基金项目:江苏省卫生健康委员会科研项目（M2020063） |
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| 中文摘要: |
| 摘要 目的：探讨血清25羟维生素D[25（OH）D]、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、铁调素（Hepcidin）与罗沙司他胶囊治疗维持性血液透析（MHD）患者肾性贫血临床疗效的关系。方法：选择2020年10月至2022年10月徐州医科大学附属医院收治的肾性贫血并使用罗沙司他胶囊治疗的137例MHD患者，根据治疗12周的效果分为有效组（86例）和无效组（51例）。治疗前检测血清25（OH）D、NGAL、Hepcidin水平，多因素Logistic回归模型分析影响罗沙司他胶囊治疗疗效的因素，受试者工作特征（ROC）曲线分析25（OH）D、NGAL、Hepcidin预测罗沙司他胶囊治疗的价值。结果：无效组治疗前血清25（OH）D水平低于有效组（P＜0.05），NGAL、Hepcidin水平高于有效组（P＜0.05）。高水平NGAL、高水平Hepcidin是罗沙司他胶囊治疗MHD患者肾性贫血无效的危险因素（P＜0.05），高水平25（OH）D、联合血液滤过或血液灌流，尿素清除指数（Kt/v）＞1.2是保护因素（P＜0.05）。25 (OH)D、NGAL、Hepcidin联合预测罗沙司他胶囊治疗疗效的曲线下面积（AUC）为0.853，高于单独指标预测。结论：MHD肾性贫血患者应用罗沙司他胶囊治疗前血清25（OH）D水平降低，NGAL、Hepcidin水平增高，上述水平变化与罗沙司他胶囊治疗效果有关，联合25（OH）D、NGAL、Hepcidin可提高对罗沙司他胶囊治疗疗效的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical efficacy of relationship between serum 25-hydroxyvitamin D [25(OH)D], neutrophil gelatinase-associated lipocalin (NGAL), Hepcidin（Hepcidin）and roxadustat capsules in the treatment of renal anemia in maintenance hemodialysis (MHD) patients. Methods: 137 MHD patients with renal anemia who were treated with roxadustat capsules in the Affiliated Hospital of Xuzhou Medical University from October 2020 to October 2022 were selected, and patients were divided into effective group (86 cases) and ineffective group (51 cases) according to the effect of 12 weeks of treatment. The serum levels of 25(OH)D, NGAL and Hepcidin were detected before treatment, the factors affecting the efficacy of roxadustat capsules were analyzed by multivariate Logistic regression model, the value of 25(OH)D, NGAL and Hepcidin in predicting the efficacy of roxadustat capsules were analyzed by receiver operating characteristic (ROC) curve. Results: The level of serum 25(OH)D in ineffective group before treatment was lower than that in effective group (P<0.05), and the levels of NGAL and Hepcidin were higher than those in effective group (P<0.05). High level of NGAL and high level of Hepcidin were risk factors for ineffective treatment of renal anemia in MHD patients with roxadustat capsules (P<0.05), high level of 25(OH)D, combined with hemofiltration or hemoperfusion, and urea clearance index (Kt/v)>1.2 were protective factors (P<0.05). The area under the curve (AUC) of 25(OH)D, NGAL, and Hepcidin combined to predict the efficacy of rosastat capsules was 0.853, which was higher than the prediction of individual indicators. Conclusion: The serum 25 (OH) D level decreased and NGAL and Hepcidin level increased in patients with MHD renal anemia before treatment with roxadustat capsules,the above level changes were related to the treatment effect of roxadustat capsules, the combination of 25(OH)D, NGAL and Hepcidin could improve the predictive value of the therapeutic effect of roxadustat capsules. |
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