1.The clinical value of baseline 18F-fluorodeoxyglucose PET/CT in predicting the prognosis of diffuse large B-cell lymphoma
Liu HE ; Cheng GU ; Bin HU ; Guoquan WANG ; Xiaoming ZHANG ; Lichun ZHENG
Journal of Practical Radiology 2025;41(9):1557-1561
Objective To investigate the clinical value of baseline 18F-fluorodeoxyglucose(18F-FDG)PET/CT metabolic parame-ters and certain clinical indicators in predicting the prognosis of patients with diffuse large B-cell lymphoma(DLBCL).Methods A retrospec-tive analysis was conducted on the baseline 18 F-FDG PET/CT data of 73 DLBCL patients who received R-CHOP treatment.Patients were divided into progression group(24 cases)and non-progression group(49 cases)based on disease progression within 2 years post-treatment.The lesion maximum standardized uptake value(SUVmax),tumour-to-liver blood pool SUVmax ratio(LLR)and tumour-to-mediastinal blood pool SUVmax ratio(L-BPR)were analyzed using receiver operating characteristic(ROC)curves.Kaplan-Meier(K-M)survival curves analysis were performed based on the optimal thresholds of SUVmax,LLR and L-BPR.x2 tests were used to analyze and compare the relationship between each parameter and disease progression.Indicators that were significant in the x2 tests were included in the multivariate Cox regression analysis.Results The area under the curve(AUC)for LLR,L-BPR,and SUVmax were 0.920,0.914,and 0.848,respectively,with optimal thresholds of 7.41,10.67,and 14.70.Based on these thresholds,K-M survival curves analysis showed that the 2-year progression-free survival(PFS)rates for DLBCL patients were 79.2%vs 30.8%(P<0.001),74.3%vs 22.0%(P=0.009),and 79.5%vs 51.6%(P=0.002),respectively.Significant differences were observed between the progression and non-progression groups in terms of LLR,L-BPR,SUVmax,extranodal involvement,international prognostic index(IPI)score,lactate dehydrogenase(LDH)level,Eastern Cooperative Oncology Group(ECOG)score,and β2-microglobulin(β2-MG)levels(P<0.05).Multivariate Cox regression analysis revealed that the IPI score and LLR were independent predictors affecting the 2-year PFS of DLBCL patients(P<0.05).Conclusion Baseline 18F-FDG PET/CT metabolic parameter LLR and IPI score are inde-pendent factors for predicting the prognosis of DLBCL patients.
2.The diagnostic value of 18F-fluorodeoxyglucose PET/CT imaging in autoimmune pancreatitis
Cheng GU ; Rui WANG ; Xinyu SHEN ; Lichun ZHENG ; Xiaoming ZHANG
Journal of Practical Radiology 2025;41(10):1669-1673
Objective To analyze the 18F-fluorodeoxyglucose(18F-FDG)PET/CT manifestations of autoimmune pancreatitis(AIP)and to explore the diagnostic value of 18F-FDG PET/CT in AIP.Methods Twenty-three patients with suspected AIP who underwent 18F-FDG PET/CT were retrospectively analyzed.Eleven patients were diagnosed with AIP based on the International Consensus Diagnostic Criteria(ICDC)of AIP published by the International Pancreatic Disease Association.The detection rate and diagnostic sensitivity of 18F-FDG PET/CT for pancreatic enlargement,duct stenosis,duct dilation,pseudocapsules,and extrapancreatic involvement were analyzed,along with the 18F-FDG PET/CT manifestations of AIP.Results The 18F-FDG PET/CT manifestations of 11 patients with AIP:9 patients(81.82%)showed diffuse pancreatic enlargement,and 2 patients(18.18%)had local pancreatic head enlargement.And metabolism showed diffuse or localized increase.The maximum standardized uptake value(SUVmax)for the early PET/CT was 1.7-9.1(4.52±1.92),and for the delayed PET/CT,it was 2.6-9.8(5.25±1.98),with a statistically signifi-cant difference between the two phases SUVmax(t=-7.627,P<0.001).Two patients showed duct stenosis,six had distal duct dilation,and three exhibited pseudocapsule formation.Extrapancreatic involvement occurred in ten patients(90.91%),including sclerosing cholangitis,bile duct dilation inside and outside the liver,gallbladder changes,lymph node involvement,salivary gland involvement,prostate involvement,retroperitoneal fibrosis,pulmonary lesions,arteritis,and granulomatous tissue formation,etc.Among them,the same patient may present with multiple manifestations of extrapancreatic involvement.Among the 11 patients,eight were diagnosed as AIP,two as pancreatic cancer,and one as acute pancreatitis by 18F-FDG PET/CT.The diagnostic sensitivity was 72.73%.Conclusion The 18F-FDG PET/CT of AIP demonstrates specificity in anatomical morphology and metabolic changes and can better display extrapancreatic involvement,which has unique clinical value in AIP imaging diagnosis.
3.Diagnostic value of 18F-FDG PET/CT and bone marrow biopsy in evaluating common non-Hodgkin lymphoma with bone marrow infiltration
Bin HU ; Liu HE ; Yang LI ; Cheng GU ; Xiaoming ZHANG ; Lichun ZHENG
Journal of China Medical University 2025;54(5):437-441,447
Objective To evaluate the diagnostic value of positron emission tomography(PET)/computed tomography(CT)and bone marrow biopsy(BMB)for bone marrow infiltration in common non-Hodgkin lymphoma(NHL).Methods We retrospectively analyzed data from 197 patients with NHL and compared the diagnostic value of PET/CT and BMB for bone marrow infiltration.Differences in PET/CT parameters and serological test results were compared between PET/CT-positive and PET/CT-negative patients as well as between BMB-positive and BMB-negative patients.Results In patients with diffuse large B-cell lymphoma(DLBCL),the sensitivities of PET/CT and BMB for detecting bone marrow infiltration were 90.5%and 66.7%,and the specificities were 95.1%and 100.0%,respectively.In patients with follicular lymphoma(FL),the sensitivities were 63.6%and 81.8%,and the specificities were 98.1%and 100.0%,respec-tively.In patients with T-cell lymphoma(TCL),the sensitivities were 60.0%and 80.0%,and the specificities were 88.0%and 100.0%,respectively.Among patients with DLBCL and TCL,significant differences were observed in platelet count and lactate dehydrogenase levels between PET/CT-positive and PET/CT-negative patients(P<0.05).Conclusion PET/CT showed excellent diagnostic perfor-mance for evaluating bone marrow infiltration in DLBCL.PET/CT had limited sensitivity for FL and TCL and might serve as a supplemen-tary tool for BMB.Platelet count and lactate dehydrogenase levels may aid in the diagnosis of bone marrow infiltration in DLBCL and TCL.
4.The clinical value of baseline 18F-fluorodeoxyglucose PET/CT in predicting the prognosis of diffuse large B-cell lymphoma
Liu HE ; Cheng GU ; Bin HU ; Guoquan WANG ; Xiaoming ZHANG ; Lichun ZHENG
Journal of Practical Radiology 2025;41(9):1557-1561
Objective To investigate the clinical value of baseline 18F-fluorodeoxyglucose(18F-FDG)PET/CT metabolic parame-ters and certain clinical indicators in predicting the prognosis of patients with diffuse large B-cell lymphoma(DLBCL).Methods A retrospec-tive analysis was conducted on the baseline 18 F-FDG PET/CT data of 73 DLBCL patients who received R-CHOP treatment.Patients were divided into progression group(24 cases)and non-progression group(49 cases)based on disease progression within 2 years post-treatment.The lesion maximum standardized uptake value(SUVmax),tumour-to-liver blood pool SUVmax ratio(LLR)and tumour-to-mediastinal blood pool SUVmax ratio(L-BPR)were analyzed using receiver operating characteristic(ROC)curves.Kaplan-Meier(K-M)survival curves analysis were performed based on the optimal thresholds of SUVmax,LLR and L-BPR.x2 tests were used to analyze and compare the relationship between each parameter and disease progression.Indicators that were significant in the x2 tests were included in the multivariate Cox regression analysis.Results The area under the curve(AUC)for LLR,L-BPR,and SUVmax were 0.920,0.914,and 0.848,respectively,with optimal thresholds of 7.41,10.67,and 14.70.Based on these thresholds,K-M survival curves analysis showed that the 2-year progression-free survival(PFS)rates for DLBCL patients were 79.2%vs 30.8%(P<0.001),74.3%vs 22.0%(P=0.009),and 79.5%vs 51.6%(P=0.002),respectively.Significant differences were observed between the progression and non-progression groups in terms of LLR,L-BPR,SUVmax,extranodal involvement,international prognostic index(IPI)score,lactate dehydrogenase(LDH)level,Eastern Cooperative Oncology Group(ECOG)score,and β2-microglobulin(β2-MG)levels(P<0.05).Multivariate Cox regression analysis revealed that the IPI score and LLR were independent predictors affecting the 2-year PFS of DLBCL patients(P<0.05).Conclusion Baseline 18F-FDG PET/CT metabolic parameter LLR and IPI score are inde-pendent factors for predicting the prognosis of DLBCL patients.
5.Diagnostic value of 18F-FDG PET/CT and bone marrow biopsy in evaluating common non-Hodgkin lymphoma with bone marrow infiltration
Bin HU ; Liu HE ; Yang LI ; Cheng GU ; Xiaoming ZHANG ; Lichun ZHENG
Journal of China Medical University 2025;54(5):437-441,447
Objective To evaluate the diagnostic value of positron emission tomography(PET)/computed tomography(CT)and bone marrow biopsy(BMB)for bone marrow infiltration in common non-Hodgkin lymphoma(NHL).Methods We retrospectively analyzed data from 197 patients with NHL and compared the diagnostic value of PET/CT and BMB for bone marrow infiltration.Differences in PET/CT parameters and serological test results were compared between PET/CT-positive and PET/CT-negative patients as well as between BMB-positive and BMB-negative patients.Results In patients with diffuse large B-cell lymphoma(DLBCL),the sensitivities of PET/CT and BMB for detecting bone marrow infiltration were 90.5%and 66.7%,and the specificities were 95.1%and 100.0%,respectively.In patients with follicular lymphoma(FL),the sensitivities were 63.6%and 81.8%,and the specificities were 98.1%and 100.0%,respec-tively.In patients with T-cell lymphoma(TCL),the sensitivities were 60.0%and 80.0%,and the specificities were 88.0%and 100.0%,respectively.Among patients with DLBCL and TCL,significant differences were observed in platelet count and lactate dehydrogenase levels between PET/CT-positive and PET/CT-negative patients(P<0.05).Conclusion PET/CT showed excellent diagnostic perfor-mance for evaluating bone marrow infiltration in DLBCL.PET/CT had limited sensitivity for FL and TCL and might serve as a supplemen-tary tool for BMB.Platelet count and lactate dehydrogenase levels may aid in the diagnosis of bone marrow infiltration in DLBCL and TCL.
6.The diagnostic value of 18F-fluorodeoxyglucose PET/CT imaging in autoimmune pancreatitis
Cheng GU ; Rui WANG ; Xinyu SHEN ; Lichun ZHENG ; Xiaoming ZHANG
Journal of Practical Radiology 2025;41(10):1669-1673
Objective To analyze the 18F-fluorodeoxyglucose(18F-FDG)PET/CT manifestations of autoimmune pancreatitis(AIP)and to explore the diagnostic value of 18F-FDG PET/CT in AIP.Methods Twenty-three patients with suspected AIP who underwent 18F-FDG PET/CT were retrospectively analyzed.Eleven patients were diagnosed with AIP based on the International Consensus Diagnostic Criteria(ICDC)of AIP published by the International Pancreatic Disease Association.The detection rate and diagnostic sensitivity of 18F-FDG PET/CT for pancreatic enlargement,duct stenosis,duct dilation,pseudocapsules,and extrapancreatic involvement were analyzed,along with the 18F-FDG PET/CT manifestations of AIP.Results The 18F-FDG PET/CT manifestations of 11 patients with AIP:9 patients(81.82%)showed diffuse pancreatic enlargement,and 2 patients(18.18%)had local pancreatic head enlargement.And metabolism showed diffuse or localized increase.The maximum standardized uptake value(SUVmax)for the early PET/CT was 1.7-9.1(4.52±1.92),and for the delayed PET/CT,it was 2.6-9.8(5.25±1.98),with a statistically signifi-cant difference between the two phases SUVmax(t=-7.627,P<0.001).Two patients showed duct stenosis,six had distal duct dilation,and three exhibited pseudocapsule formation.Extrapancreatic involvement occurred in ten patients(90.91%),including sclerosing cholangitis,bile duct dilation inside and outside the liver,gallbladder changes,lymph node involvement,salivary gland involvement,prostate involvement,retroperitoneal fibrosis,pulmonary lesions,arteritis,and granulomatous tissue formation,etc.Among them,the same patient may present with multiple manifestations of extrapancreatic involvement.Among the 11 patients,eight were diagnosed as AIP,two as pancreatic cancer,and one as acute pancreatitis by 18F-FDG PET/CT.The diagnostic sensitivity was 72.73%.Conclusion The 18F-FDG PET/CT of AIP demonstrates specificity in anatomical morphology and metabolic changes and can better display extrapancreatic involvement,which has unique clinical value in AIP imaging diagnosis.
7.Down-regulation of miR-152-3p expression reduces resistance to paclitaxel of paclitaxel-resistant ovarian cancer cells A2780T
Yang ZHANG ; Chen'ge ZHAO ; Lichun CHENG ; Huiyi LYU ; Di WU
Chinese Journal of Pharmacology and Toxicology 2024;38(1):22-30
OBJECTIVE To investigate the effect and mechanism of miR-152-3p on the resistance to paclitaxel(PTX)of PTX-resistant ovarian cancer cells(A2780T cells).METHODS ① Ovarian cancer parent cells(A2780 cells)and A2780T cells were treated with PTX(1.875,3.75,7.5,17 and 23 μmol·L-1)for 48 h.Cell viability was evaluated by MTT assay,and the 50%inhibitory concentration(IC50)and drug resistance index of A2780T cells were calculated.Western blotting was used to detect the expres-sions of resistance protein P-glycoprotein(P-gp),multidrug resistance related protein 1(MRP1)and adenosine triphosphate binding transporter G superfamily member 2(ABCG2).② Real-time fluorescent quantita-tive PCR(RT-qPCR)was used to detect the expressions of miR-152-3p in A2780 and A2780T cells.The lipid-mediated transient transfection technique was employed to transfect the miR-152-3p inhibitor to reduce miR-152-3p expression in A2780T cells(miR-152-3p inhibitor group),while the negative control(miR-152-3p NC)group was established.RT-qPCR was used to detect transfection efficiency,and the MTT method,scratch experiment,and flow cytometry were used to investigate the effects of the trans-fecting miR-152-3p inhibitor on survival,migration and apoptosis of A2780T cells.Western blotting was used to detect the protein expressions of Bax and Bcl-2 in A2780T cells.③ Bioinformatics analysis of databases including miRDB,Targetscan,miRWalk,and Starbase predicted the target genes of miR-152-3p that were verified by Western blotting to detect the protein expression of PTEN in A2780T cells of the miR-152-3p inhibitor and miR-152-3p NC groups,and RT-qPCR to detect the PTEN mRNA expression in A2780 and A2780T cells.Then,the lipid-mediated transient transfection technique was used to transfect PTEN siRNA to silence PTEN expression in A2780T cells(PTEN siRNA group).The siRNA negative control(siRNA NC)group was established.RT-qPCR was used to detect transfection efficiency,the MTT method was employed to measure the survival rate and IC50 value,and Western blotting was used to assess the protein expressions of P-gp,MRP1,and ABCG2 in A2780T cells after silencing PTEN expression.RESULTS ①After treatment with PTX,the cell survival rates were decreased in A2780 and A2780T cells(P<0.05),and the resistance index of A2780T cells was 2.8.Compared with A2780 cells,the protein expressions of P-gp and MRP1 and ABCG2 were highly expressed in A2780T cells(P<0.05,P<0.01).② RT-qPCR showed that the expression of miR-152-3p in A2780T cells was higher than that of A2780 cells(P<0.01).Compared with the miR-152-3p NC group,A2780T cell viability(P<0.05,P<0.01)and cell migration capability(P<0.05)were significantly inhibited,while the apoptosis rate increased(P<0.01)in miR-152-3p inhibitor group.Moreover,the protein expression of Bax was increased(P<0.01),but Bcl-2 decreased(P<0.05).③ Bioinformatics analysis suggested that PTEN was a target gene of the miR-152-3p,and the verified results showed that the PTEN protein expression in A2780T cells of the miR-152-3p inhibitor group was lower than that of the miR-152-3p NC group(P<0.05),and PTEN mRNA expression in A2780T cells was higher than that in A2780 cells(P<0.01).After silencing the expression of PTEN in A2780T cells,the cell viability was significantly reduced(P<0.05,P<0.01),while the IC50 value was reduced(P<0.01)compared with the siRNA NC group.In addition,the protein expressions of P-gp,MRP1 and ABCG2 were decreased(P<0.05,P<0.01).CONCLUSION miR-152-3p is highly expressed in A2780T cells,and down-regulation of its expression may inhibit proliferation and migration,prompt apoptosis and reduce the resistance to PTX of A2780T cells,which is made possible by inhibiting expression of its target gene PTEN.
8.The value of PET/CT combined with serum LDH,β2-MG and CRP in the differential diagnosis of sarcoidosis and lymphoma
Bin HU ; Liu HE ; Huan ZHANG ; Cheng GU ; Xinyu SHEN ; Xiaoming ZHANG ; Lichun ZHENG
Journal of Practical Radiology 2024;40(12):2037-2040,2070
Objective To investigate the differential diagnostic value of 18F-fluorodeoxyglucose(18F-FDG)/PET/CT combined with serum lactate dehydrogenase(LDH),β2-microglobulin(β2-MG),and C-reactive protein(CRP)in sarcoidosis and lymphoma.Methods The 18F-FDG PET/CT images of 19 patients with sarcoidosis and 33 patients with lymphoma were analyzed retrospectively.The lymph node maximum diameter,density,distribution morphology,maximum standardized uptake value(SUVmax),extra-nodal involvement,and serum LDH,β2-MG,and CRP results were analyzed and compared.Results There was no statistically significant difference between sarcoidosis and lymphoma in lymph node density,necrosis rate,and SUVmax(P>0.05).There was statistically significant difference in the maximum diameter between lymph nodes in sarcoidosis(2.4±0.7)cm and lymphoma(3.3±1.3)cm(P<0.05).The incidence of symmetric enlargement of mediastinal and hilar lymph nodes was 84.2%in sarcoidosis,the lymph node fusion rate was 21.1%,the lung involvement rate was 57.8%,the spleen involvement rate was 10.5%,and the rates of lymphoma were 15.2%,63.6%,0.0%,and 36.4%,with statistically significant differences(P<0.05).There were statistically significant differences in LDH and β2-MG between the two groups(P<0.05),but the differences in CRP were not statistically significant(P>0.05).Conclusion PET/CT can show the anatomy of mediastinal and hilar lymph nodes and extra-nodal affected organs as well as glucose metabolism,showing a certain differential diagnostic value of sarcoidosis and lymphoma when combined with serum LDH and β2-MG levels.
9.Quantitative analysis of foot kinematics in patients with early Parkinson′s disease under dual task
Haohao WANG ; Xiaofan XUE ; Dongtao LIU ; Zhou LONG ; Cheng WANG ; Lichun ZHOU
Chinese Journal of Neurology 2024;57(3):255-265
Objective:To investigate the gait characteristics of patients with early Parkinson′s disease (PD) under cognitive dual task, and to provide sensitive kinematic indicators for the early diagnosis, timely treatment and reasonable rehabilitation of PD.Methods:A total of 62 outpatients and inpatients with early non-tremor Parkinson′s disease in Shijingshan Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University from September 2021 to August 2023 were selected as experimental group (PD group), and 62 healthy controls with comparable age composition ratio were selected as control group. The baseline data, Montreal Cognitive Assessment Scale scores, and the gait assessment scores of the motor part of the Unified Parkinson′s Disease Rating Scale were compared between the 2 groups. The wearable gait analysis device was used to collect the gait parameters of the 2 groups of subjects under single task and dual task, and the foot kinematic characteristics of the patients with early PD were quantified. Independent sample t test and Mann-Whitney U test were used to analyze the gait parameters of the 2 groups. The statistically significant variables were included in Logistic regression analysis to explore the association between gait parameters and PD. Finally, the diagnostic value of the variables was estimated by receiver operating characteristic (ROC) curve analysis. Results:Gait spatio-temporal parameters (per gait cycle): (1) The gait speed of the PD group was slower than that of the control group [(1.01±0.12) m/s vs (1.22±0.18) m/s, t=-7.526] during single task walking. The bipedal support time in the PD group was significantly longer than that in the control group [(0.29±0.05) s vs (0.22±0.06) s, t=6.659]. The differences were both statistically significant (both P<0.001). (2) During dual-task walking, PD patients showed slower gait speed [(0.88±0.11) m/s vs (1.19±0.16) m/s, t=-12.158, P<0.001]. The bipedal support time in the PD group was longer than that in the control group [(0.36±0.05) s vs (0.22±0.05) s, t=12.828, P<0.001]. PD patients had shorter stride length [(109.20±6.21) cm vs (112.77±5.87) cm, t=-3.203, P=0.010]. Stride frequency in the PD group was higher than that in the control group [(114.45±7.10) steps/min vs (110.87±7.16) steps/min, t=2.724, P=0.020]. The single leg support time was longer than that of the control group [(0.49±0.12) s vs (0.45±0.06) s, t=2.643, P=0.020] , and the differences were statistically significant. Gait kinematics parameters: (1) During single task walking, the maximum angle of foot movement in the sagittal plane in the PD group was smaller than that in the control group (17.19°±2.37° vs 19.71°±2.92°, t=-4.691, P<0.001). The minimum angle of movement in the sagittal plane was smaller than that in the control group (-67.08°±4.63° vs -70.10°±3.94°, t=0.395, P=0.001). The minimum horizontal angle of the foot during exercise in the PD group was lower than that in the control group (9.08°±4.02° vs 11.80°±3.60°, t=-3.461, P<0.001). The minimum angle of the foot coronal plane in the PD group was smaller than that in the control group (-10.55°±2.87° vs -12.04°±2.31°, t=2.831, P=0.030; the negative sign only represents the movement direction). The touch angle of the foot in the PD group was significantly lower than that in the control group (11.14°±2.78° vs 12.78°±3.57°, t=-2.779, P=0.030). (2) During dual-task walking, the maximum sagittal angle (15.44°±2.54° vs 18.99°±2.71°, t=-6.673, P<0.05), the minimum angle of sagittal plane (-65.68°±4.73° vs -70.02°±4.04°, t=-4.747, P<0.001; the negative sign only represents the direction of movement), the minimum coronal movement angle (-11.15°± 2.99° vs -13.18°±2.50°, t=3.642, P=0.020), the touch angle (11.01°±3.10° vs 12.83°±4.01°, t=-2.438, P=0.010), the minimum horizontal angle (8.83°±4.04° vs 11.83°±3.63°, t=-3.776, P<0.001), and the change of the angle from the ground (-65.00°±3.54° vs -67.06°±3.61°, t=3.133, P<0.001) in the PD group were all smaller than that in the control group. The differences were all statistically significant. Logistic regression analysis showed that step frequency was positively correlated with PD ( OR=1.124,95% CI 1.040-1.201, P=0.001), minimum angle of coronal plane was positively correlated with PD ( OR=1.501, 95% CI 1.040-2.151, P=0.030). Stride length was negatively correlated with PD ( OR=0.902, 95% CI 0.830-0.978, P=0.010). ROC curve was used to evaluate the diagnostic value of step frequency, stride length and minimum angle of coronal plane. For step frequency, when the maximum Youden index was 0.880, the best cut-off value to distinguish the PD group from the control group was 115.000, the sensitivity was 0.577, the specificity was 0.710, and the area under the curve was 0.656. For the minimum coronal angle, when the maximum Youden index was 0.251, the best cut-off value was -12.575, the sensitivity was 0.728, the specificity was 0.531, and the area under the curve was 0.670. For stride length, when the maximum Youden index was 0, the best cut-off value was 100.91, the sensitivity was 0.950, the specificity was 0.050, and the area under the curve was 0.300. Conclusions:Some gait parameters such as step frequency and minimum angle of coronal plane can be used as kinematic markers to reflect the gait characteristics of early PD, which may be helpful in tracking and evaluating the gait disorder characteristics of early PD patients and predicting the risk of PD. Some gait parameters of PD patients are significantly different from those of healthy people during cognitive-motor dual-task walking.
10.Clinical comparative study of roxadustat and recombinant human erythropoietin in the treatment of non-dialysis stage 3 to 5 chronic kidney disease and renal anemia
Cheng CHEN ; Tianfu TONG ; Lichun XU ; Kai YANG ; Qijie ZHANG
Chinese Journal of Postgraduates of Medicine 2023;46(11):966-971
Objective:To compare the clinical curative effect of roxadustat and recombinant human erythropoietin (rhEPO) on non-dialysis stage 3 to 5 chronic kidney disease (CKD) combined with renal anemia (RA).Methods:A total of 108 patients with non-dialysis stage 3 to 5 CKD and RA admitted to Jiangbei Branch of Zhongda Hospital Affiliated to Southeast University were prospectively enrolled between January 2020 and October 2022. According to random number table method, they were divided into group A and group B, 54 cases in each group. The group A was treated with roxadustat and polysaccharide-iron complex (PIC) for 3 months, while group B was treated with rhEPO and PIC for 3 months. The clinical curative effect, levels of hemoglobin (Hb), red blood cell count (RBC), hematocrit (Hct), serum ferritin (SF), transferrin saturation (TSAT), transferrin (TRF), blood urea nitrogen (BUN), serum creatinine (Scr) and β2-microglobulin (β2-MG) before and after treatment, and the incidence of adverse reactions during treatment in the two groups were compared.Results:The total response rate of treatment in group A was significantly higher than that in group B: 87.04% (47/54) vs. 70.37% (38/54), and the difference was statistically significant ( P<0.05). After treatment, levels of RBC, Hb and Hct in group A were significantly higher than those in group B: (3.47 ± 0.59) × 10 12/L vs. (2.60 ± 0.51) × 10 12/L, (110.45 ± 12.97) g/L vs. (93.64 ± 10.58) g/L, 0.358 ± 0.054 vs. 0.303 ± 0.043, and the difference was statistically significant ( P<0.05). The levels of TSAT, SF and TRF in group A were significantly higher than those in group B: (35.17 ± 3.65)% vs. (29.82 ± 3.10)%, (286.74 ± 17.23) μg/L vs. (243.16 ± 15.49) μg/L, (2.76 ± 0.45) g/L vs. (2.40 ± 0.32) g/L, and the difference was statistically significant ( P<0.05). The levels of BUN, Scr and β2-MG in group A were significantly lower than those in group B: (3.98 ± 0.41) mmol/L vs. (4.36 ± 0.54) mmol/L, (62.57 ± 7.89) μmol/L vs. (80.34 ± 9.65) μmol/L, (1.50 ± 0.42) μg/L vs. (1.99 ± 0.58) μg/L, and the difference was statistically significant ( P<0.05). During treatment, incidence of adverse reactions in group A was significantly lower than that in group B: 11.11% (6/54) vs. 25.93% (14/54), and the difference was statistically significant ( P<0.05). Conclusions:Compared with rhEPO, roxadustat has better curative effect, which can effectively relieve anemia and improve iron metabolism in patients with non-dialysis stage 3 to 5 CKD and RA, with good safety.

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