【摘要】 目的 探讨人尿激肽原酶治疗急性缺血性脑卒中的成本-效果。方法 96例急性缺血性脑卒中患者作为研究对象,依据治疗方案的不同分为观察组(47例)与对照组(49例)。两组患者均给予阿司匹林和氯吡格雷、他汀类药物口服治疗,并按相应的情况进行对症治疗；观察组在上述常规治疗的基础上于起病48 h内加用人尿激肽原酶。比较两组治疗效果、住院费用情况、成本-效果,分析治疗成本敏感度。结果 治疗后,观察组的总有效率为91.49%,高于对照组的73.47%,差异具有统计学意义(P<0.05)。两组患者在治疗期间均未发生与药物相关的不良事件。3个月随访期间内均无脑卒中复发病例。两组患者均未出现脑卒中复发住院产生的医疗费以及药物相关不良事件造成的费用。观察组的药费、其他费用、总费用虽高于对照组,但组间比较差异无统计学意义(P>0.05)。直接医疗成本-效果比较显示,观察组每获得1个单位效果花费120.36元,低于对照组的142.35元,观察组具有显著的临床经济效益。单因素敏感度分析结果表明,敏感度分析与成本-效果分析两者的趋势是一致的,提示成本-效果分析结果可信。结论 人尿激肽原酶能显著改善急性缺血性脑卒中患者的神经功能缺损,临床疗效显著,而且有更优的成本-效果比。更多还原

【Abstract】 Objective To discuss the cost-effectiveness of human urinary kallidinogenase in the treatment of acute ischemic stroke. Methods A total of 96 patients with acute ischemic stroke were divided into observation group(47 cases) and control group(49 cases) according to different treatment regiments. Both groups were given oral aspirin, clopidogrel and statins and symptomatic treatment according to the corresponding situation, on this basis, the observation group was give human urinary kallidinogenase within 48 h from the onset of disease. The therapeutic effect, hospitalization cost and cost-effectiveness of the two groups were compared, and the sensitivity of treatment cost was analyzed. Results After treatment, the total effective rate of the observation group was 91.49%, which was higher than that of 73.47% of the control group, and the difference was statistically significant(P<0.05). There were no drug-related adverse events during the treatment period in both groups.There were no cases of stroke recurrence during the 3-month follow-up period. There were no medical cost for hospitalization due to recurrent stroke and no cost for drug-related adverse events in both groups. Although the drug cost, other cost and total cost of the observation group were higher than those of the control group, there was no statistically significant difference between the groups(P>0.05). The direct medical cost-effectiveness comparison showed that the observation group spent 120.36 yuan per unit of effect, which was lower than that of 142.35 yuan in the control group, and the observation group had significant clinical economic benefits. The results of single factor sensitivity analysis showed that the results of sensitivity analysis and cost-effectiveness analysis was consistent, suggesting that the results of the cost-effectiveness analysis was credible. Conclusion Human urinary kallidinogenase can significantly improve neurological deficits in patients with acute ischemic stroke, with significant clinical effect and a better cost-effectiveness ratio.更多还原