rhTPO等四种升血小板药物临床应用评价及经济学评估

Evaluation of effectiveness and pharmacoeconomics of four elevating platelet drugs including rhTPO

目的:评价rh-TPO、rhIL-11、复方皂矾丸、氨肽素四种升血小板药物用于各种血小板减少的疗效及经济学意义。方法:采用病例调查方法逐日锁定2009年2–5月间用药的住院病人共计265例,通过PASS系统追踪用药情况,评价疗效并观察用药安全性;数据资料采用SPSS软件进行对比性分析。结果:rhIL-11升血小板效果较好,也具有很好的成本效果比,其增量成本-效果比尤其有意义。rhTPO虽然效果最好,能短时间有效提高严重骨髓抑制导致的血小板下降,但成本-效果比较高。氨肽素的成本-效果比最低,但对重度骨髓抑制导致的血小板下降疗效不佳。结论:rhIL-11可以作为白血病患者等升血小板治疗的首选,rhTPO适用于有经济承受能力的患者,氨肽素建议用于血小板下降1、2级状态,如效果不明显可配合使用rhIL-11。

Objective： To evaluate the effectiveness and pharmacoeconomics of four elevating platelet drugs including rhTPO, rhIL-11, compound Zaofan pills, ampeptide elemente on thrombopenia patients. Methods： Data of 265 inpatients using the four elevating platelet drugs were investigated by HIS from February to May in 2009. The curative effect and safety in drug use were analyzed. The data were computed by SPSS software. Results： Among the four drugs, effect of elevating platelet of rhIL-11 was good, with low cost-effectiveness ratio, and especially, the A C/A E showed significance. The rhTPO can rapidly elevate the platelet in bone marrow suppression, but its cost-effectiveness ratio was the most highest. Although its cost-effect iveness ratio was the lowest one, ampeptide elemente had little effect on the thrombocytopenia induced by severe bone marrow suppression. Conclusion： rhIL-11 can be regarded as the first selection drug in treating thrombopenia, especially in leucocythemia patients. It is suggested that rhTPO should be suitable for patients in good financial support. It is suggested that ampeptide elemente should be used in the patients with platelet dropping 1 to 2 levels, and if necessary, combination with rhlL-11 can improve curative effect.