我国急性病毒性肝炎最佳分型诊断路径探讨

Study on the most effective etiologic diagnosis strategy of acute viral hepatitis in China

目的 探讨急性病毒性肝炎病原学分型诊断最佳路径 .方法 系统综述、成本效果分析 .结果 根据我国历史文献 ,用系统综述方法分析我国急性病毒性肝炎构成比 ,十二条分型路径中以 HBV→ HAV→ HEV→ HCV诊断费用最低 ,134 0 3.44元 /千病例 ,成本效果比 (CER)为 13.84.其次为HBV→ HAV→ HCV→ HEV,HAV→ HBV→ HEV→ HCV和HAV→ HBV→ HCV→ HEV.结论 目前我国现行急性病毒性肝炎分型诊断方法 (甲、乙、丙、戊型肝炎同时检测 )的成本最高 ,散发季节以 HBV→ HAV→ HEV→ HCV的诊断路径最为经济 ,基本可以完成分型诊断任务 ,而在甲型肝炎出现爆发时以路径 HAV→ HBV→ HEV→ HCV最经济 .

AIM To seek the most effective etiology diagnosis strategy of acute viral hepatitis. METHODS Systemic review and cost effectiveness analysis were employed. RESULTS According to domestic historical documents, the systemic review was adopted to analyze the proportion of acute viral hepatitis in China, it was demonstrated that hepatitis A accounted for 39.29%, hepatitis B 37.75%, hepatitis C 4.80%, hepatitis E 10.35%. Among the 12 routes, the route HBV→HAV→HEV→HCV was the most economical, 13 403.44 yuan (R.M.B), cost effectiveness ratio (CER)value 13.84. CONCLUSION Current diagnostic strategy (all the possible hepatitis A B C and E virus are detected) is most expensive. In the sporadic season, the route HBV→HAV→HEV→HCV is most economical, while hepatitis A outbreaks, the route HAV→HBV→HEV→HCV is most economical.