绝经后妇女原发性高脂血症4种治疗方案的疗效及成本-效果分析

Cost- effectiveness Analysis and Safety Evaluation of Four Kinds of Primary Hyperlipidemia Treatment Programs for Postmenopausal Women

目的:比较4种抗绝经后妇女原发性高脂血症方案的临床疗效和安全性,用药物经济学方法进行成本-效果分析。方法:采用随机对照临床研究方法,将符合标准的患者随机分成A组(阿托伐他汀钙片)、B组(瑞舒伐他汀钙片)、C组(非诺贝特缓释胶囊)和D组(非诺贝特缓释胶囊联合辛伐他汀分散片)。疗程均为2个月。治疗前后分别测定各组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)等指标,进行成本-效果分析及安全性评价。结果:A、B、C、D组患者2个月的治疗成本分别为265.8元、246.6元、235.2元和364.5元。在TC、TG和HDL-C等指标上C组成本-效果比最小。在LDL-C指标上B组方案最优。结论:当绝经后妇女原发性高脂血症患者的体检结果以LDL-C过高为主,可优先选择B组方案,如主要问题为TC、TG和HDL-C超标时,可优先选择C组方案。

Objective： To compare the clinical effects of 4 kinds of treatment programs for postmenopausal women on primary hypedipidemia, and to analyze their cost-effectiveness and evaluate their safety with the medical economics method. Methods：The randomized controlled clinical study was used. 104 postmenopausal women with primary hyperlipi-demia were divided into 4 group： Group A （atorvastatin calcium tablets）, Group B （rosuvastatin calcium tablets ）, Group C （fenofibrate sustained-release capsules） and Group D（ fenofibrate sustained-release capsules combined with simvastatin dis- persible tablets）, respectively. The patients were treated for 2 months. Such indicators as TC, TG, LDL-C HDL-C were measured before and after the treatment. The cost-effectiveness ratio and safety evaluation were analyzed. Results：The cost of Group A, B, C and D was 265.8,246.6, 235.2 and 364.5 RMB, respectively. After the analysis, the cost-effective-ness ratio of Group C was the lowest in their TC, TG and HDL-C indicators and that of Group B was the lowest in the LDL-C indicator. Conclusion：When TC, TG and HDL-C for postmenopausal women were high, they could select Group C pro- gram while those who had their high LDL-C could select Group B program.