四种药物治疗门静脉高压性胃病急性出血的成本-效果分析

Cost-effectiveness analysis of four pharmacotherapeutic schemes for the patients with acute bleeding portal hypertensive gastropathy

目的评价肝硬化门静脉高压性胃病（PHG）急性出血的四种药物治疗方案的成本-效果比。方法肝硬化PHG急性出血患者共70例,分别选用奥曲肽、生长抑素、特利加压素和垂体后叶素治疗,应用药物经济学成本-效果分析法进行分析。结果奥曲肽、生长抑素、特利加压素、垂体后叶素四组治疗PHG急性出血的有效率分别为100%、100%、100%、80%,药物费用分别为1 891．5元、2 970．6元、5 520元、65元,成本．效果比分别为18．91、29．71、55．2、0．81。结论在治疗PHG急性出血的药物选择上应首先考虑应用成本-效果比最低的垂体后叶素治疗,在经济条件允许、效果不佳或伴有心脑血管疾病时可及时更换生长抑素类药物。

Objective To evaluate the cost and effectiveness of four pharmacotherapeutic schemes for the patients with acute bleeding portal hypertensive gastropathy. Methods 70 patients with acute bleeding PHG were treated by different drugs ： octreotide （ 20 ）, stilamin （ 20 ）, terlipressin （ 15 ）, pituitrin （ 15 ）. Evaluation was carried out with pharmacoeconomic cost-effectiveness analysis. Results The hemostatic rates of octreotide,stilamin,terlipressin and pituitrin for the patients with acute bleeding PHG were 100 %, 100 %, 100 % and 80 % , respectiv.ely. The costs of octreotide, stilamin terlipressin and pituitrin schemes were RMB 1891.5,2970.6,5520, and 65 yuan, respectively. Conclusions According to the evaluation with pharmacoeconomic cost-effectiveness analysis,the therapeutic scheme of pituitrin should be first considered for the patients with acute bleeding PHG. If the curative effect of pituitrin seems to be unsatisfactory or the patient has problems with blood vessels while his economic condition allows, the growth inhibition medicine can be considered.