磺脲类药物继发失效患者不同治疗方案的成本-效果及对生存质量的影响

Different Therapeutic Regimens for Diabetic Patients with Sulfonylureas Secondary Failure:Cost-Effectiveness Analyses and Evaluation of Life Quality

目的了解磺脲类药物继发失效(SSF)的糖尿病患者不同治疗方案的成本-效果及对生存质量的影响。方法用药物经济学成本-效果分析方法和糖尿病生存质量量表(DSQOL)比较SSF4种治疗方法(A组预混人胰岛素;B组瑞格列奈+二甲双胍;C组瑞格列奈+阿卡波糖;D组格列吡嗪+二甲双胍+中效胰岛素)的成本-效果及对生存质量的影响。结果A组疗效最好,成本-效果比显著低于其余各组,生理、心理维度评分的改善高于其余各组,社会关系维度评分改善低于其余各组,均有显著性差异,治疗维度评分改善与其余各组无差异。结论胰岛素能以最低成本取得最好疗效,对患者的生理、心理改善最优。

OBJECTIVE： To compare the cost- effectiveness and quality of survival among different therapeutic regimens for diabetic patients with sulfonylureas secondary failure（SSF） .METHODS：The cost - effectiveness and the effects on patients life quality of four therapeutic schemes（group A： mixed- human insulin; group B： repaglinide and metformin; group C： repaglinide and acarbose; group D： glipizide, metfonmin and novolin N） were compared using cost-effectiveness analysis in pharmacoeconomics and DSQOL（diabetic patients＇ score on quality of life） .RESULTS：Group A showed the best clinical efficiency, with cost-effectiveness ratio significantly lower, physiological and psychological dimension scores significantly higher and social dimension score significantly loWer than in all the other 3 groups, and all were of significant differences, but no significant differences were noted in therapeutic dimension score as compared with the other 3 groups.CONCLUSION： Insulin is optimal among four schemes in the treatment of diabetic patients with sulfonylureas secondary failure in the cost - effectiveness analysis, and it has the best efficacy in the improvement of patients＇ physiology and psychology.