【摘要】 目的 探究聚乙二醇化重组人粒细胞集落刺激因子（PEG-rhG-CSF）对比短效重组人粒细胞集落刺激因子（rhG-CSF）在乳腺癌患者中的临床应用价值及成本-效果分析。方法 回顾性收集2020年1月～2023年12月于我院就诊的乳腺恶性肿瘤患者，根据纳排标准，最终纳入179例，分为PEG-rhG-CSF组（80例）与rhG-CSF组（99例），比较两组患者的临床资料，并构建Markov模型进行成本-效果分析（CEA），以质量调整生命年（QALYs）为主要终点，增量成本效果比（ICER）为经济学指标。结果 PEG-rhG-CSF组4级骨髓抑制发生率显著低于rhG-CSF组（1.25%vs. 12.12%,P=0.048），两组3、4级化疗导致的中性粒细胞减少（CIN）发生率组间比较差异有统计学意义（16.25%vs. 29.29%,P=0.041）。PEG-rhG-CSF组的中性粒细胞百分比中位数更高（63.20%vs. 54.40%,P<0.001）。与rhG-CSF组相比，PEG-rhG-CSF组的ICER为88 723.69元/QALYs，较rhG-CSF组高出0.24个QALYs。成本-效果可接受曲线（CEAC）显示，当意愿支付（WTP）≥89 179元/QALYs时，PEG-rhG-CSF具有91.76%的经济性优势概率。结论 PEG-rhG-CSF在降低重度骨髓抑制风险、改善中性粒细胞恢复方面显著优于rhG-CSF，且长期应用具有成本-效果优势，建议作为高危乳腺癌患者化疗的优选预防策略。更多还原

【Abstract】 Objective To evaluate the clinical value and cost-effectiveness analysis of pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF) versus short-acting recombinant human granulocyte colony-stimulating factor(rhG-CSF) in breast cancer patients receiving chemotherapy. Methods A retrospective review of medical records was conducted for breast cancer patients treated at our hospital from Jan 2020 to Dec 2023. Of these, 179 met the inclusion criteria and were divided into PEG-rhG-CSF group(n=80) and rhG-CSF group(n=99). Baseline characteristics and clinical data were compared between the two groups. A Markov model was constructed for cost-effectiveness analysis(CEA), with quality-adjusted life years(QALYs) as the primary endpoint and incremental cost-effectiveness ratio(ICER) as the cost-effectiveness indicator. Results The incidence of grade 4 myelosuppression was significantly lower in the PEG-rhG-CSF group than in the rhG-CSF group(1.25 % vs. 12.12 %, P=0.048), and the incidence of grade 3/4 chemotherapy-induced neutropenia(CIN) also differed significantly between the groups(16.25 % vs. 29.29 %, P=0.041). The median neutrophil percentage was higher in the PEG-rhGCSF group(63.20 % vs. 54.40 %, P<0.001). The ICER of PEG-rhG-CSF compared with rhG-CSF was 88,723.69 CNY/QALYs, with an incremental gain of 0.24 QALYs. The cost-effectiveness acceptability curve(CEAC) showed that when the willingnessto-pay(WTP) threshold was ≥89, 179 CNY/QALYs, PEG-rhG-CSF had a 91.76 % probability of being cost-effective. Conclusion PEG-rhG-CSF significantly outperformed rhG-CSF in reducing the risk of severe myelosuppression and improving neutrophil recovery, while demonstrating long-term cost-effectiveness advantages. It is recommended as the preferred prophylactic strategy for high-risk breast cancer patients undergoing chemotherapy.更多还原