植物细胞中紫杉醇提取物在癌症化疗中的成本效果分析

Cost-effectiveness Analysis of Paclitaxel Extract from Plant Cells in Cancer Chemotherapy

为了提高植物细胞中紫杉醇药物的提取效率,本研究对丙酮/水分级沉淀法从植物细胞培养物中纯化紫杉醇的工艺方法进行试验。研究结果表明:室温加水工艺下,丙酮/水的比例为40∶60、30∶70、20∶80和10∶90(v/v)时,紫杉醇产率分别为54.3%、89.1%、95.5%和97.6%;在丙酮/水比为40∶60(v/v),并在低温下混合10min时,可立即获得高产率(87.9%)的紫杉醇;增加蒸馏水的比例或降低加入水可大幅提高紫杉醇的产率。通过乳腺癌诊断标准选取乳腺癌患者60例,随机分为2组,一组使用国产紫杉醇,另一组使用进口紫杉醇,3个疗程后通过影像学检查分析药物疗效,并通过最小成本分析法分析国产和进口紫杉醇对乳腺癌患者的成本疗效评价,可知国产组和进口组紫杉醇对乳腺癌的疗效并无明显差异,但是国产组紫杉醇可显著降低单位疗程紫杉醇平均费用。

In order to improve the extraction efficiency of paclitaxel in plant cells, a process for the purification of paclitaxel from plant cell culture by acetone/water fractionation was studied. The results showed that the yield of paclitaxel was 54.3%, 89.1%, 95.5% and 97.6%, respectively, when the ratio of acetone to water was 40∶60, 30∶70, 20∶80 and 10∶90 (v/v) at room temperature. When the acetone/water ratio was 40∶60 (v/v) and mixed at low temperature for 10 minutes, high yield (87.9%) of paclitaxel was immediately obtained. Increasing the proportion of distilled water or lowering the amount of water added can greatly increase the yield of paclitaxel. Sixty patients with breast cancer were selected by breast cancer diagnostic criteria and randomly divided into two groups. One group used domestic paclitaxel and the other group used imported paclitaxel. After three courses, the drug efficacy was analyzed by imaging examination and analyzed by minimum cost analysis. The cost-effectiveness of domestic and imported paclitaxel in breast cancer patients showed that there was no significant difference in the efficacy of paclitaxel between the domestic group and the imported group for paclitaxel, but the domestic group paclitaxel could significantly reduce the average cost of paclitaxel per unit of treatment.