本文關(guān)鍵詞： 藥物性肝損傷 注射用還原型谷胱甘肽 異甘草酸鎂注射液 多烯磷脂酰膽堿注射液 胃腸道腫瘤 藥物經(jīng)濟(jì)學(xué)　出處：《中國藥房》2017年29期 　論文類型：期刊論文

【摘要】：目的:觀察3種藥物對胃腸道腫瘤患者化療致肝損傷的預(yù)防作用和安全性,并對其進(jìn)行經(jīng)濟(jì)學(xué)評價(jià)。方法:選擇2014-2015年我院收治的確診為胃腸道惡性腫瘤并且有全身化療適應(yīng)證的患者128例,按照隨機(jī)數(shù)字表法分為A組(42例)、B組(46例)和C組(40例)。從化療第1天起,A、B、C組患者每天分別給予注射用還原型谷胱甘肽(1.2 g)、異甘草酸鎂注射液(100 mg)和多烯磷脂酰膽堿注射液(465 mg)預(yù)防化療致肝損傷,療程均為7 d。觀察3組患者的肝損傷預(yù)防效果和不良反應(yīng)發(fā)生情況,并進(jìn)行經(jīng)濟(jì)學(xué)分析。結(jié)果:A、B、C組患者的總有效率分別為90.48%、97.83%和87.50%,B組明顯高于其他兩組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);但A、C組之間比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。A、B、C組方案的成本分別為1 465.86、1 518.94、1 554.04元,采用最小成本分析法對A、C兩組方案進(jìn)行評價(jià),得出A組方案更經(jīng)濟(jì);采用成本-效果分析法對A、B兩組方案進(jìn)行評價(jià),得出A、B組方案的成本-效果比分別為1 620.09、1 552.63,增量成本-效果比為722.18,B組方案更經(jīng)濟(jì)。敏感度分析結(jié)果支持前述結(jié)論。B組中有3例患者出現(xiàn)短暫性的血壓升高,停藥2~3 d后恢復(fù)。結(jié)論:異甘草酸鎂注射液對胃腸道腫瘤患者化療致肝損傷的預(yù)防效果和經(jīng)濟(jì)性均優(yōu)于注射用還原型谷胱甘肽和多烯磷脂酰膽堿注射液,但使用期間需密切監(jiān)測患者血壓水平;注射用還原型谷胱甘肽更適用于有高血壓基礎(chǔ)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.
【作者單位】： 上海市同仁醫(yī)院/上海交通大學(xué)醫(yī)學(xué)院附屬同仁醫(yī)院藥學(xué)部;
【基金】：上海市藥學(xué)會醫(yī)院藥學(xué)科研項(xiàng)目(No.2015-YY-01-18)
【分類號】：R735;R956

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