【摘要】 目的 对糖尿病患者不同糖化血红蛋白（HbA1c）水平的长期卫生成本和健康获益进行计算，定量展示该指标的改善所带来的长期价值。方法 基于糖尿病发生发展情况，构建包含无并发症（S状态）、并发症（C状态）和死亡（D状态）的三状态马尔科夫（Markov）模型，检索已发表文献获取模型计算参数取值，对不同HbA1c水平的长期卫生成本和健康获益（以QALYs表示）进行计算，获取其变化率，并对重要计算变量进行敏感性分析。结果 HbA1c水平每降低1%，可增加0.348 5 QALYs，并增加41 536元长期成本。敏感性分析显示健康获益分析的结果较稳健，而卫生成本分析的结果变异性较大，尤其S和C状态下的卫生成本的影响最大。结论 HbA1c水平的改变能带来健康获益和卫生成本的改变，定量化的研究结果对卫生决策有重要意义。更多还原

【Abstract】 Objective To calculate the relationship between glycated hemoglobin(HbA1c) level and long-term health outcome(QALYs) and cost. Methods Developing a 3-status markov model including non-complication(S state), complication(C state), and death. Calculating long-term health outcome and cost with different HbA1c level, and getting gradient rate. Results With 1% HbA1c decreasing, QALYs will increase 0.348 5 and cost will increase 41,536 CNY as well. Sensitivity analysis shows result for QALYs is robust and result for cost is much more variable, especially for the costs of S state and C state. Conclusion Improvement of HbA1c level could bring benefit of health outcomes and change of health cost. The quantitative result could support healthcare decision-making.更多还原