CTE和MRE对炎症性肠病的诊断价值及卫生经济学分析

Diagnostic Value and Health Economical Evaluation of CTE and MRE in the Diagnosis of Inflammatory Bowel Disease

目的探讨CT小肠造影(CTE)和磁共振小肠造影(MRE)诊断炎症性肠病(IBD)的应用价值并进行卫生经济学分析。方法搜集经病理确诊的160例IBD初诊患者,分析其CTE、MRE的扫描结果,分别比较CTE、MRE对IBD的诊断准确率,以及各方案的成本效果比(cost-effectiveness ratio,CER)。结果CTE、MRE扫描诊断准确率分别为83.8%(67/80)、86.3%(69/80),CTE与MRE的诊断结果之间的差异性无统计学意义(χ^(2)=2.064,P=0.109)。CTE及MRE诊断IBD的成本分别为1901.5元、2285.2元,CTE及MRE诊断IBD的成本效果比分别为2270.4、2649.5。结论从卫生经济学范畴考虑,CTE可作为诊断IBD的首选影像学检查,存在CTE检查禁忌的患者以及对X线电离辐射敏感的孕妇、儿童以及反复治疗后效果评估的患者可由MRE代替。

Objective To investigate the value of CTE and MRE in the diagnosis of inflammatory bowel disease(IBD)and to analyze the health economics.Methods 160 cases of newly diagnosed patients with inflammatory bowel disease diagnosed by endoscopy,imaging and pathological examination were collected.The results of CTE,MRE were analyzed.The accuracy of CTE and MRE in the diagnosis of IBD were compared,as well as the cost-effectiveness ratio and cost effect incremental of each program.Results The diagnostic accuracy of CTE and MRE was 83.8%(67/80),86.3%(69/80),respectively.There was no significant difference between CTE and MRE(χ^(2)=2.064,P=0.11).The diagnosis cost of CTE and MRE for IBD was 1901.5 yuan and 2285.2 yuan,respectively.The cost-effectiveness ratios of CTE and MRE for IBD diagnosis were 2270.4 and 2649.5,respectively.Conclusion From the perspective of health economics,CTE can be used as the preferred imaging test for the diagnosis of IBD.Patients with contraindications to CTE and pregnant women,children who are sensitive to X-ray ionizing radiation,and patients after repeated treatments can be evaluated by MRE.Economic conditions allow Under the circumstances,CTE combined with MRE is more conducive to improving the diagnosis rate of IBD.