甘露醇与甘油果糖治疗脑梗死后脑水肿的药物经济学分析

Pharmacoeconomic Evaluation of Manicol vs. Glycerol Fructose for Brain Edema after Cerebral Infarction

目的:对甘露醇、甘油果糖治疗急性脑梗死后脑水肿的方案进行回顾性经济学分析。方法:将200例患者按病情分成一般脑梗死患者(170例)、脑梗死伴肾功能异常患者(30例),每类患者采用随机单盲法分成甘露醇组与甘油果糖组,观察2组的临床疗效和不良反应,并根据临床疗效的不同进行相应的药物经济学评价。结果:14d后甘露醇组与甘油果糖组治疗一般脑梗死患者的总有效率分别为92.9%、95.3%(P>0.05),不良反应发生率分别为3.5%、2.4%,治疗总费用分别为(4146.45±282.15)、(4807.20±318.15)元,经最小成本分析甘露醇组为优选方案;治疗脑梗死伴肾功能异常患者的总有效率分别为80.0%、93.3%(P<0.05),不良反应发生率分别为26.7%、13.3%,治疗总费用分别为(4335.32±295.50)、(5034.57±322.49)元,经成本-效果分析甘油果糖组为优选方案。结论:治疗一般脑梗死患者以甘露醇为优选方案,治疗脑梗死伴肾功能异常患者以甘油果糖为优选方案。

OBJECTIVE： To conduct a pharmacoeconomic evaluation on Manicol vs. Glycerol Fructose in the treatment of the brain edema after cerebral infarction. METHODS： A total of 200 patients divided into two categories （170 had common cerebral infarction and 30 had cerebral infarction complicating renal dysfunction） and each category was subdivided into two groups by randomized single blind method. The clinical therapeutic effects and adverse drug reactions were observed, and the pharmacoeconomic evaluation on the two groups was performed as well. RESULTS： For the common cerebral infarction patients after treatment by Manicol vs. Glycerol Fructose for 14 days, the total effective rates stood at 92.9% and 95.3% respectively（P 〉0.05）, the incidence of adverse drug reactions were 3.5% and 2.4%, respectively and the total treatment costs were （4 146.45 ± 282.15） yuan and （4 807.20 ± 318.15） yuan, respectively; and the cost- minimization analysis showed that manicol was the preferred therapy as compared with Glycerol Fructose. In the treatment of the patients with cerebral infarction complicating renal dysfunction, the total effective rates of the two drugs were 80.0% and 93.3%, respectively（P （0.05）, the incidence of adverse drug reactions were 26.7% and 13.3%, respectively, and the total treatment costs were（4 335.32± 295.50） yuan and （5 034.57 ± 322.49） yuan, respectively; and the cost- effectiveness analysis showed that Glycerol Fructose was the preferred therapy as compared with manicol. CONCLUSION： Manicol is the preferred therapy for common cerebral infarction whereas Glycerol Fructose is the preferred one for cerebral infarction complicating renal dysfunction.