罗沙司他联合多维训练治疗老年血透患者微炎症及内皮功能的临床研究OA

Objective To investigate the effects of roxadustat capsules combined with multi-dimensional exercise rehabilitation training on microinflammation and vascular endothelial function in elderly hemodialysis patients.Methods Elderly patients who underwent regular dialysis and took roxadustat capsules were randomly divided into the treatment group and the control group according to the random number table.Patients in the control group took roxadustat capsules.Patients in the treatment group were given roxadustat capsules combined with multi-dimensional exercise rehabilitation training.For those weighing less than 60 kg,treated with roxadustat capsules 100 mg per time;for those weighing more than 60 kg,took roxadustat capsules 120 mg each time;three times a week.The multidimensional exercise included resistance exercise,aerobic exercise,and mindfulness meditation during dialysis,3 times per week,70 minutes each session,lasting 6 months.Clinical efficacy,microinflammatory factor indicators,endothelial function indicators,biochemical indicators,and adverse drug reactions were collected before and after the study.Results A total of 235 cases were enrolled in this study.The treatment group included 115 cases.The control group included 120 cases.After the treatment,the total effective rates of the treatment group and the control group were 90.43％(104 cases/115 cases)and 79.17％(95 cases/120 cases),respectively,and the difference was statistically significant(P＜0.05).The total effective rate in the non-diabetic patients of the treatment group was 94.38％(84 cases/89 cases),significantly higher than the 80.65％(75 cases/93 cases)in the diabetic patients of the treatment group(P＜0.05).After treatment,the levels of serum nuclear transcription factor(NF-κB)in the treatment and the control groups were(24.78±4.67)and(36.09±4.25)ng·L-1,respectively;interleukin-6(IL-6)levels were(25.38±4.24)and(28.47±4.62)ng·L-1;interferon-γ(IFN-γ)levels were(40.66±4.89)and(50.01±5.95)ng·L-1;serum endothelin-1(ET-1)levels were(87.41±26.59)and(120.70±28.52)ng·L-1;soluble vascular cell adhesion molecule-1(sVCAM-1)levels were(2 848.50±84.75)and(5 639.82±125.63)μg·L-1;and plasma endothelial microparticles(EMP)counts were(95.43±20.19)and(110.55±26.78)per μL,respectively.The above indicators in the treatment group were statistically significantly different from those in the control group(all P＜0.05).The main adverse drug reactions in the treatment group and the control group were nausea,vomiting,indigestion and fatigue.The total incidence of adverse drug reaction rates in the treatment group and the control group were 11.30％(13 cases/115 cases)and 11.67％(14 cases/120 cases),respectively.There was no statistically significant difference(P＞0.05).Conclusion Roxadustat capsules combined with multidimensional exercise rehabilitation training has shown significant efficacy in microinflammation and vascular endothelial dysfunction in elderly hemodialysis patients,which can reduce microinflammatory responses and improve vascular endothelial function,outperforming the effects of roxadustat capsules alone,with good safety.