阿片受体拮抗剂治疗重度颅脑损伤的疗效评价及药物经济学分析  

Clinical studies on antagonists of opiate receptor in treatment of acute cerebral trauma and pharmacoeconomic evaluation

作　　者：潘敏莺 

机构地区：[1]浙江省浦江县人民医院,浦江322200

出　　处：《海峡药学》2013年第6期272-274,共3页Strait Pharmaceutical Journal

摘　　要：目的探讨重度颅脑损伤患者治疗中应用阿片受体拮抗剂的临床疗效及药物经济学效果。方法利用医院信息管理系统,将124例重型颅脑损伤患者随机分为纳洛酮组和纳美芬组。纳洛酮组在常规治疗基础上静脉滴注盐酸纳洛酮注射液,纳美芬组在常规治疗基础上静脉注射盐酸纳美芬注射液。观察比较两组的意识苏醒时间、APACHE-II评分、临床疗效,并用药物经济学成本-效果分析方法进行比较。结果两组患者意识苏醒时间明显缩短,APACHE-II评分降低,总有效率分别为77.42%、83.87%,两组比较,纳美芬比纳洛酮有更强疗效的趋势,但无统计学差异(P>0.05)。两组成本分别为35174.78元、37931.37元。成本-效果分析发现,两组成本-效果比无明显差异。结论纳洛酮和纳美芬两种治疗方案成本效果比无明显差异,但考虑到纳洛酮治疗方案较为繁琐,纳美芬治疗重度颅脑损伤是较为合理的选择。OBJECTIVE To evaluate the clinical efficacy and pharmacoeconomic efficacy of antagonists of opiate receptor for acute eerbral trauma. METHODS By using hospital information management sysem,a total of 124 patients with acute cerebral trauma were given randomly to divide into the naloxone group （n = 62 ） and the nalrnefene group （n = 62）. After all patients were hospitalized routine, the naloxone group were given naloxone hydro- chloride injection, the nalmefene group were given nalmefene hydroehloride injection. To observe all patient＇s awak- ening time, the APACHE-II grading, and analyzes two groups of clinical effects and pharmaeoeeonomie evalua- tion. RESULTS The awakening mean time were shortened obviously with two groups of patients, the APACHE-II grading to reduce obviously. The effective rates of naloxone group vs. nalmefene group were 77.42% vs. 83.87%. The total effeetivenes of nalmefene group are on the better trend than the naloxone group. But the difference between two groups had no statistical significance （P 〉 0. 05 ）. The costs of naloxone group vs nalmefene group were 35174. 78 yuan vs. 37931.37 yuan. The eost-effeetivenes ratio in naloxone group had no vious difference than in nalmefene group. CONCLUSION The costeffeetivenes ratio in naloxone group had no vious difference than in nalrnefene group. But allowed for tedious therapeutic plan additional naloxone, naloxone is a reasonable alternative for acute cerebral trauma.

关 键 词：药物经济学 重度颅脑损伤 阿片受体拮抗剂 纳洛酮 纳美芬 

分 类 号：R969.4[医药卫生—药理学]