3种用药方案治疗HIV/TB患者抗结核药物性肝损伤成本-效果分析

Cost-effectiveness Analysis of 3 Therapeutic Schemes in Treating Antituberculosis Drug-induced Hepatotoxicity in HIV/TB Patients

目的探讨3种不同治疗方案用于治疗HIV/TB患者抗结核药物性肝损的经济效果。方法将168例患者随机分成3组,A组还原型谷胱甘肽序贯、B组复方甘草酸苷序贯,C组还原型谷胱甘肽静滴序贯复方甘草酸苷口服,观察疗效和不良反应。结果 3种药物治疗方案成本分别为1221元、1076.5元、960.7元;发生不良反应率分别为50%、41.1%、44.6%(P>0.05);成本-效果比分别为12.91、12.83、10.55;有效率分别为94.6%、83.8%、91.1%(P<0.05);三种方案治疗HIV/TB患者抗结核药物性肝损在有效率上无显著差异,在A、B两组肝功能上(总胆红素)有显著差异。结论还原型谷胱甘肽静滴序贯复方甘草酸苷口服方案为较佳方案。

Objective To probe into the economic-effectiveness of different therapeutic schemes in the treatment of antitubercnlo- sis drug-induced hepatotoxicity in HIV/TB patients. Method 168 cases were randomly divided into three groups, including Group A （ se- quential therapy of deoxidized glutathione）, Group B （sequential therapy of compound glycyrrhizin） and Group C （sequential therapy of deoxidized glutathione vein and compound glycyrrhizin orally）. Results The costs for the 3 treatment schemes were respectively 1221 yuan, 1076.5 yuan and 960. 7 yuan ; their incidences for adverse effects were respectively 50%, 41.1% and 44.6% （ P 〉 0. 05 ） ; the cost-effectiveness ratio were respectively 12. 91,12.83 and 10. 55 ; the effective rates were respectively 94. 6%, 83.8% and 91.1% ; There were no significant differences in the effective rates produced respectively by three therapeutic schemes when they were used to treat the antituberculosis drug-induced hepatotoxicity in HIV/TB patients, while there was a significant difference in the liver function （Total bilirubin） between Group A and Group B. Conclusion Taking everything into consideration, schemes C is the preferable one.