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目的对特利加压素与生长抑素治疗食管胃静脉曲张出血进行成本-效用分析,比较2种药物的经济性。方法构建1个出血、不出血、再次出血、死亡4个疾病状态的离散仿真模拟模型,模型的转换概率来源于对文献的Meta分析;用于计算质量生命年各个状态的健康效用值来源文献,成本数据来源医疗机构采集的数据分析。对基础分析的结果采用单因敏感性分析。结果特利加压素与生长抑素相比,治疗食管胃静脉曲张出血每多获得1个质量生命年的成本为65 478.84元;敏感性分析结果显示,每多获得1个质量生命年的成本最高为110 289.46元,低于3倍人均GDP可接受标准。若采用药物说明书中用药时间计算的成本做敏感性分析,则存在成本较低,效果较好的情况。结论同生长抑素相比,特利加压素治疗食管胃静脉曲张出血具有经济性。
Objective To evaluate the cost-effectiveness of terlipressin and somatostatin in the treatment of esophageal and gastric variceal bleeding, and to compare the economy of the two drugs. Methods A discrete simulation model of bleeding, bleeding, re-bleeding and death was established. The conversion probability of the model was derived from the Meta analysis of the literature. The health utility values used to calculate the quality of life in each state were derived from literature, Cost Data Source Data collected by medical institutions. The results of the basic analysis using single-factor sensitivity analysis. Results Compared with somatostatin, the cost of terlipressin in treating esophagogastric variceal bleeding was 65 478.84 Yuan per extra mass life year. Sensitivity analysis showed that the cost of obtaining one mass life year Up to 110 289.46 yuan, less than 3 times the per capita GDP acceptable standards. If the use of drugs in the drug manual calculation of the cost of doing the sensitivity analysis, there is a lower cost, the better the situation. Conclusion Compared with somatostatin, terlipressin is an economical treatment for esophageal and gastric variceal bleeding.