【摘要】 目的 比较马破伤风免疫球蛋白[F（ab’）₂]与破伤风抗毒素（TAT）用于预防破伤风梭菌感染短期被动免疫的经济性，为临床用药决策及卫生资源配置提供循证依据。方法 系统检索PubMed、The Cochrane Library、EMBASE、中国知网（CNKI）、万方、维普等数据库，收集马破伤风免疫球蛋白F（ab’）₂与TAT用于破伤风梭菌感染短期被动免疫的对照研究，按照预设纳排标准筛选文献，根据文献的干预措施不同分成TAT组（对照组）和马破伤风免疫球蛋白F（ab’）₂组（试验组），采用Rev Man5.4软件对两组过敏反应发生率进行Meta分析；基于真实世界成本数据，以人均患者成本[对照组111.23元、试验组86.66元]为基础，结合Meta分析得到的过敏反应发生率结果，采用成本-效果分析计算增量成本-效果比（ICER），同时通过敏感性分析验证结果稳定性。结果 成本方面：试验组人均治疗成本86.66元，对照组111.23元。效果方面：试验组过敏反应发生率0.37%，对照组过敏反应发生率6.08%。经济学评价：试验组C/E为86.98元（每提高1%避免过敏反应发生率的成本），对照组为118.43元；ICER为-430.30元。相较于对照组，试验组每提高1%避免过敏反应发生率可节约430.30元。敏感性分析：（成本波动±5%）显示，ICER波动范围为-3621.22～-237.20，始终为负值，结果稳定。结论 马破伤风免疫球蛋白F（ab’）₂在预防破伤风梭菌感染短期被动免疫中，不仅能显著降低过敏反应发生率，还能减少治疗总费用，具有显著的成本-效果优势。更多还原

【Abstract】 Objective To compare the cost-effectiveness of Tetanus Immunoglobulin F（ab’）₂, Equine and Tetanus Antitoxin（TAT） for short-term passive immunization against Clostridium tetaniinfection, providing evidence-based support for clinical medication decisions and healthcare resource allocation. Methods A systematic search was conducted in databases including PubMed, The Cochrane Library, EMBASE, CNKI, WanFang, and VIP. Comparative studies on Tetanus Immunoglobulin F（ab’）₂, Equine and TAT for short-term passive immunization against Clostridium tetaniinfection were collected. Literature was screened according to predefined inclusion and exclusion criteria and divided into the TAT group（control group） and the Tetanus Immunoglobulin F（ab’）₂, Equine group（experimental group） based on interventions. Metaanalysis of the incidence of allergic reactions in both groups was performed using RevMan 5.4 software. Based on real-world cost data, with perpatient costs [control group: 111.23 yuan, experimental group: 86.66 yuan] as the baseline, combined with the incidence of allergic reactions derived from the Meta-analysis, a cost-effectiveness analysis was conducted to calculate the incremental cost-effectiveness ratio（ICER）. Sensitivity analysis was also performed to verify the stability of the results. Results In terms of cost, the per-patient treatment cost in the experimental group was 86.66 yuan, compared to 111.23 yuan in the control group. In terms of effectiveness, the incidence of allergic reactions was 0.37% in the experimental group and 6.08% in the control group. Economic evaluation: The C/E ratio for the experimental group was 86.98 yuan（cost per 1% increase in avoided allergic reaction incidence）, and 118.43 yuan for the control group; the ICER was-430.30 yuan. Compared to the control group, the experimental group saved 430.30 yuan for each 1% increase in avoided allergic reaction incidence. Sensitivity analysis（cost fluctuation ±5%） showed that the ICER fluctuated within the range of-3,621.22 to-237.20, remaining consistently negative, indicating stable results. Conclusion Tetanus Immunoglobulin F（ab’）₂, Equine not only significantly reduces the incidence of allergic reactions but also lowers the total treatment cost in short-term passive immunization against Clostridium tetaniinfection, demonstrating significant cost-effectiveness advantages.更多还原