重组人尿激酶原与阿替普酶治疗急性ST段抬高型心肌梗死的成本效果分析

Cost effectiveness analysis of recombinant human Pro urokinase and alteplase in treatment of acute ST-segment elevation myocardial infarction

目的:评价重组人尿激酶原和阿替普酶治疗急性ST段抬高型心肌梗死(STEMI)的经济性。方法:采用回顾性分析方法,选择2016全年我省收治的STEMI患者共133例,根据给予药物分为重组人尿激酶原组和阿替普酶组。评价两组的临床心肌梗死溶栓再通率、不良反应发生率,并进行成本效果分析。结果:重组人尿激酶原组临床心肌梗死溶栓再通率与阿替普酶组无统计学意义,不良反应发生率明显低于阿替普酶组(P<0.01)。重组人尿激酶原组的成本效果比为252.22元,阿替普酶组的成本效果比高于重组人尿激酶原组,为253.62元。增量成本效果比为145.48,敏感性分析与成本效果分析结果一致。结论:重组人尿激酶原治疗STEMI疗效好,不良反应小,具有成本效果优势,为优选方案。

Objective： To compare the cost-effectiveness between alteplase and recombinant human Pro urokinase in treatment of acute ST-segment elevation myocardial infarction. Methods： A total of 133 STEMI patients admitted during 2016 were divided into aheplase group and recombinant human Pro urokinase group. In the two groups, clinical myocardial infarction thrombolytic reeanalization rate, adverse reaction rate were evaluated, and the C/E was analyzed. Results： There was no significant difference in clinical myocardial infarction thrombolytic recanalization rate between alteplase group and recombinant human Pro urokinase group. In recombinant human Pro urokinase group, the incidence rate of adverse reactions was significantly lower than this in the alteplase group （P 〈 0.01）. The C/E ratio in recombinant human Pro urokinase group was 252.22 yuan, it was lower than that in alteplase group which was 253.62 yuan. ICER is 145.48. The results of sensitivity analysis and cost-effectiveness analysis are consistent. Conclusion： Recombinant human Pro urokinase in treatment of STEMI has good curative effect, less adverse reactions and the advantages of cost effectiveness. Recombinant human Pro urokinase is the optimum scheme.