生长抑素、特利加压素及奥曲肽治疗食管胃底静脉曲张破裂出血成本—效果分析

Cost-effectiveness analysis of somatostatin, terlipressin and octreotide in the treatment of esophageal and gastric varices bleeding

目的 研究生长抑素、特利加压素及奥曲肽治疗食道胃底静脉曲张破裂出血经济效果。方法 选择来自我院2009年1月~2016年4月152例食道胃底静脉曲张破裂出血患者,随机分成四组：国产生长抑素组;进口生长抑素组;特利加压素组;奥曲肽组;分析四组有效率、成本、成本-效果比、敏感度及副反应发生率。结果 国产生长抑素组、进口生长抑素组、特利加压素组和奥曲肽组有效率分别为85.0%、88.1%、88.2%和86.1%,四组比较无统计学差异;特利加压素组成本、成本-效果比及增量成本最高,国产生长抑素组最低;四组副反应发生率均较低。结论 国产生长抑素、进口生长抑素、特利加压素和奥曲肽均能有效治疗食管胃底静脉曲张破裂出血,在获得同等效果的基础上,国产生长抑素和奥曲肽所花单位成本较低,其中国产生长抑素最低,进口生长抑素较高,特利加压素最高。

Objective To study the economic effect of somatostatin, terlipressin and octreotide in the treatment of esophageal and gastric variees bleeding. Methods A total of 152 patients with esophageal and gastric variees bleeding who were in our hospital from January 2009 to April 2016 were randomly assigned into four groups： the home-made so- matostatin group; the imported somatostatin group; the terlipressin group; the oetreotide group; effective rate, cost, cost- effectiveness ratio, sensitivity and the incidence rate of side effects were analyzed. Results The effectfve rates of home- made somatostatin, imported somatostatin, terlipressin and octreotide were 85.0%, 88.1%, 88.2% and 86.1% respec- tively. There was no significant difference. The cost, cost effectiveness and incremental cost in terlipressin group were the highest, those in the home-made somatostatin group were the lowest, and terlipressin the highest. The incidence rate of side effects was low in all four groups. Conclusion Home-made somatostatin, imported somatostatin, terlipressin and octreotide are effective in the treatment of esophageal and gastric varices bleeding. On the basis of the same effect, home-made somatostatin and octreotide have lower cost per unit, in which the home-made somatostatin is the lowest, imported somatostatin is higher, and terlipressin is the highest.