持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析  

Cost-effectiveness analysis on continuous subcutaneous insulin infusion and multi-point daily insulin injections in the treatment program of type 2 diabetes

作　　者：舒同[1] 曾龙驿[1] 穆攀伟[1] 王曼曼[1] 张国超[1] 陈燕铭[1] 

机构地区：[1]中山大学附属第三医院内分泌科,广州510630

出　　处：《中华流行病学杂志》2009年第7期737-739,共3页Chinese Journal of Epidemiology

摘　　要：目的比较新入院的2型糖尿病患者使用持续皮下胰岛素输注（CSII）和胰岛素每日多点注射（MDI）控制2型糖尿病血糖达标的成本效果。方法回顾性分析86例使用CSⅡ方案和103例使用MDI方案控制血糖的新入院2型糖尿病患者，观察时间为2周，运用药物经济学中的成本效果分析法对两种治疗方案进行评价。结果治疗2周后，CSⅡ组与MDI组患者血糖控制有效率相似，差异无统计学意义（P〉0．05）；CSⅡ组低血糖反应发生率及夜间低血糖发生率较MDI组明显降低（P〈0．05），其他不良反应发生率相似；CSII方案成本（元／人）比MDI方案低（1478．34 vs．1620．46），差异有统计学意义（P〈0．05）；成本效果比（C／E）显示CSⅡ组为15．07，MDI组为16134，差异无统计学意义（P〉0．05）；再以成本较低的CSⅡ组方案为参照，增量的成本效果比（AC／AE）MDI组为129．20。结论使用CSⅡ方案控制新入院2型糖尿病患者治疗的成本效益较MDI方案好，CSⅡ方案是住院期间胰岛素强化治疗的较优选择。Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion （CS Ⅱ） and multi-point daily insulin injections （MDI） in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a ＇blood sugar control program＇ among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CSⅡ group was similar to the MDI group, with no significant difference（P〈0.05） and the adverse reactions were similar. Costs in the CS II program （Yuan/person） was less than in the MDI program （ 1478.34 vs. 1620.46 ）, with significant differences （ P〈 0.05 ）. The cost-effectiveness ratios （C/E） were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference （P〉0.05）. In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio （AC/ AE） of the MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.

关 键 词：2型糖尿病 持续皮下胰岛素输注 胰岛素每日多点注射 成本效果分析 

分 类 号：R587.1[医药卫生—内分泌] R1[医药卫生—内科学]