阿德福韦酯与中药制剂治疗HBeAg阴性慢性乙型肝炎成本—效果分析  

Cost-effectiveness Analysis on the Treatments of HBeAg Negative CHB Between Adefovir Dipivoxil and Chinese Medicine Preparation

作　　者：王宁[1] 

机构地区：[1]石家庄市第五医院,河北石家庄050021

出　　处：《抗感染药学》2007年第4期198-200,共3页Anti-infection Pharmacy

基　　金：河北省石家庄市2005年科技攻关计划(课题编号:051201253)

摘　　要：目的：对阿德福韦酯与中药制剂——慢肝1号降低HBeAg阴性患者HBV-DNA和ALT的水平进行成本效果分析。方法：选取在本院就诊HBV-DNA病毒负荷〉1．0×10^4cops／mL，且ALT〉40 U／L的CHB患者198例，分别使用阿德福韦酯片（88例）和慢肝1号冲剂（110例）治疗。疗程48周以上，以HBV-DNA作为抗病毒疗效观察指标，ALT及临床症状改善作为疗效观察指标，以药物成本效果比作为药物经济学指标。结果：阿德福韦酯片与慢肝1号冲剂两组疗效（HBV-DNA转阴率）有显著性差异（P〈0．05），阿德福韦酯片优势大于慢肝1号冲剂（42％〉20％）；增量成本效果比（△C／△E）中阿德福韦酯片痊愈率为（-145．82％）低于慢肝1号冲剂，表明阿德福韦酯片在降低ALT方面有优势。结论：阿德福韦酯片降低HBV-DNA有明显疗效，在降低ALT水平方面得到药物经济学的推荐。Objective： To study the cost- effectiveness analysis on the levels of decreasing serum HBV DNA and serum ALT in patients with hepatitis B e-antigen （HBeAg） negative chronic hepatitis B treated with adefovir dipi-voxil or Chinese medicine preparation. Methods： We randomly assigned 198 patients with HBeAg-negative chronic hepatitis B in which serum HBV DNA levels were more than 1.0× 10^4copies/ml and serum ALT levels more than 40 IU/L to receive either adefovir dipivoxil（n=88） or Mangan I （n =110） for above 48 weeks. Serum HBV DNA levels were detected as the antiviral parameter, serum ALT levels and the improvement of clinical symptom as the effective parameters, and the cost- effectiveness ratio of drugs as the pharmacoeconomic index. Results： 42 percent of patients who in the adefovir dipivoxil group had obvious improvement in normalized serum HBV DNA levels ,as compared with 20 percent of patients in the Mangan I group（P〈0.05）.The recovery rate in the increased cost-effectiveness ratios was lower with adefovir dipivoxil treatment than with Mangan I ,which indicated that serum ALT levels declined rapidly after receiving adefovir dipivoxil. Conclusion： Adefovir dipivoxil can obviously lower serum HBV DNA levels in patients with HBeAg-negative chronic hepatitis B.It can also reduce serum ALT levels, which should have a great value in the pharmacoeconomics.

关 键 词：阿德福韦酯 慢肝1号冲剂 成本-效果分析 

分 类 号：R956[医药卫生—药学]