3种药物预防胃肠道肿瘤患者化疗致肝损伤的临床观察和经济学评价
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篇名: 3种药物预防胃肠道肿瘤患者化疗致肝损伤的临床观察和经济学评价
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摘要: 目的:观察3种药物对胃肠道肿瘤患者化疗致肝损伤的预防作用和安全性,并对其进行经济学评价。方法:选择2014-2015年我院收治的确诊为胃肠道恶性肿瘤并且有全身化疗适应证的患者128例,按照随机数字表法分为A组(42例)、B组(46例)和C组(40例)。从化疗第1天起,A、B、C组患者每天分别给予注射用还原型谷胱甘肽(1.2 g)、异甘草酸镁注射液(100 mg)和多烯磷脂酰胆碱注射液(465 mg)预防化疗致肝损伤,疗程均为7 d。观察3组患者的肝损伤预防效果和不良反应发生情况,并进行经济学分析。结果:A、B、C组患者的总有效率分别为90.48%、97.83%和87.50%,B组明显高于其他两组,差异有统计学意义(P<0.05);但A、C组之间比较,差异无统计学意义(P>0.05)。A、B、C组方案的成本分别为1 465.86、1 518.94、1 554.04元,采用最小成本分析法对A、C两组方案进行评价,得出A组方案更经济;采用成本-效果分析法对A、B两组方案进行评价,得出A、B组方案的成本-效果比分别为1 620.09、1 552.63,增量成本-效果比为722.18,B组方案更经济。敏感度分析结果支持前述结论。B组中有3例患者出现短暂性的血压升高,停药2~3 d后恢复。结论:异甘草酸镁注射液对胃肠道肿瘤患者化疗致肝损伤的预防效果和经济性均优于注射用还原型谷胱甘肽和多烯磷脂酰胆碱注射液,但使用期间需密切监测患者血压水平;注射用还原型谷胱甘肽更适用于有高血压基础疾病的患者。
ABSTRACT: OBJECTIVE: To observe the preventive effects and safety of 3 kinds of drugs on chemotherapy-induced liver damage in patients with  gastrointestinal tumors, and to evaluate economics. METHODS: A total of 128 patients with gastrointestinal malignant tumor and systemic chemotherapy indication selected from our hospital during 2014-2015 were divided into group A (42 cases), B (46 cases) and C (40 cases) according to random number table. Since the first day of chemotherapy, group A, B and C were given Reduced glutathione for injection (1.2 g), Magnesium isoglycyrrhizinate injection (100 mg) and Polyene phosphatidylcholine injection (465 mg) for preventing chemotherapy-induced liver damage respectively, for 7 d. The preventive effects and ADR occurrence were observed in 3 groups, and the economic analysis was conducted. RESULTS: Total response rates of group A, B and C were 90.48%, 97.83% and 87.50%, and that of group B was significantly higher than other 2 groups, with statistical significance (P<0.05). But there was no statistical significance between group A and C (P>0.05). The costs of group A, B and C were 1 465.86, 1 518.94, 1 554.04 yuan, and cost-minimization analysis was adopted to evaluate the plans of group A and C. The plan of group A was more economical. Cost-effectiveness analysis was used to evaluate the plans of group A and B, cost-effectiveness ratio of group A and B were 1 620.09 and 1 552.63; incremental cost-effectiveness ratio was 722.18, and the plan of group B was more economical. The above conclusion was supported by the results of sensitivity analysis. Three patients in group B suffered from transient elevated blood pressure and then recovered 2-3 d after drug withdrawal. CONCLUSIONS: The preventive effects and economics of Magnesium isoglycyrrhizinate injection is better than Reduced glutathione for injection and Polyene phosphatidylcholine injection for chemotherapy-induced liver damage in patients with gastrointestinal tumors. The blood pressure of patients should be monitored closely during application. Reduced glutathione for injection is more suitable for patients with primary hypertensive disease.
期刊: 2017年第28卷第29期
作者: 李琴,李玲
AUTHORS: LI Qin,LI Ling
关键字: 药物性肝损伤;注射用还原型谷胱甘肽;异甘草酸镁注射液;多烯磷脂酰胆碱注射液;胃肠道肿瘤;药物经济学
KEYWORDS: Drug-induced liver damage; Reduced glutathione for injection; Magnesium isoglycyrrhizinate injection; Polyene phosphatidylcholine injection; Gastrointestinal tumor; Pharmacoeconomics
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