房颤患者预防卒中的药物经济学评价

Pharmacoeconomical Evaluation of Atrial Fibrillation Patients in Preventing their Stroke

目的:探索房颤患者预防卒中的经济用药模式。方法:随机抽取我院心脏科2003～2008年住院的236例房颤患者病例,用最小成本法进行药物经济学评价。结果:使用华法林组和未使用华法林组直接医疗成本分别为2 264.79元和1 515.29元,两组差异有统计学意义(P<0.05)。其中伴卒中低中危风险的患者使用华法林组直接医疗成本为2 671.52元,未使用华法林组为1 398.66元。伴卒中高危风险的患者使用华法林组直接医疗成本为2 182.09元,未使用华法林组为1 625.35元,两组差异有统计学意义(P<0.05)。结论:卒中中、低危风险的房颤患者使用非华法林药物预防卒中是经济的,且符合相关指南;高危风险者使用非华法林药物虽然经济,但不符合相关指南。

Objective：o find a more economic medication pattern of atrial fibrillation patients in preventing their stroke. Method：236 cases of inpatients diagnosed as atrial fibrillation were randomly selected during Jan. 2003 to Dec. 2008 in the Cardiology Department of our hospital. A primary pharmacoeconomic evaluation was conducted with the Cost Minimization Analysis method. Result： The direct medical costs of the patients using warfarin was 2 264.79 yuan, and those not using warfarin was 1 515.29 yuan （P 〈 0.05 ）. The patients with low and medium risk of stroke cost 2 671.52 yuan when they used warfarin but 1 398.66 yuan when they did not use warfarin. The patients with high risk of stroke cost 2 182.09 yuan but 1 625.35 yuan when not using warfarin （P 〈0.05）. Conclusion：It was economical and was conformed to the guideline for the atrial fibrillation patients with low and medium risk of stroke not to use warfarin to prevent their stroke, while it was economical but was not conformed to the guideline for patients with high risk of stroke not to use warfarin.