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

发布时间：2018-03-01 20:39

本文关键词： 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　出处：《中国药房》2017年29期 　论文类型：期刊论文

【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(P0.05);但A、C组之间比较,差异无统计学意义(P0.05)。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 effect and safety of three drugs on liver injury induced by chemotherapy in patients with gastrointestinal cancer. Methods: a total of 128 patients with gastrointestinal malignancies and indications of systemic chemotherapy were selected from 2014 to 2015. From the first day of chemotherapy, patients in group A and group C were given reduced glutathione 1.2 g / g, magnesium isoglycyrrhizinate injection 100 mg / d and polyenylphosphatidyl (Phosphatidyl), respectively. Choline injection (465mg) was used to prevent liver injury caused by chemotherapy. The course of treatment was 7 days. The preventive effect of liver injury and the occurrence of adverse reactions in three groups were observed, and the economic analysis was carried out. Results the total effective rates of group C were 90.48% and 87.50%, respectively, which were significantly higher than those of the other two groups. The difference was statistically significant (P 0.05), but there was no significant difference between group A (P 0.05). The cost of group C was 1 465.86 / 1 518.949 / 1 554.04 yuan respectively. The minimum cost analysis method was used to evaluate the two groups, and the results showed that group A was more economical. Cost-effect analysis method was used to evaluate the two groups of AZB schemes. The results showed that the cost-effect ratio of group A B was 1 620.09 / 1 552.63, and the ratio of incremental cost to effect was 722.18 / B, respectively. The sensitivity analysis indicated that there were three patients with transient elevated blood pressure in group B. Conclusion: magnesium isoglycyrrhizinate injection can prevent liver injury induced by chemotherapy in patients with gastrointestinal neoplasms and is better than reduced glutathione and polyenylphosphatidylcholine injection for injection of Glutathione and polyenylphosphatidylcholine. However, blood pressure should be closely monitored during use; reduced glutathione for injection is more suitable for patients with essential hypertension.
【作者单位】：上海市同仁医院/上海交通大学医学院附属同仁医院药学部;
【基金】：上海市药学会医院药学科研项目(No.2015-YY-01-18)
【分类号】：R735;R956

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