深圳市新生儿乙肝免疫预防策略优化研究:基于Markov模型的成本-效果分析  

Analysis of Shenzhen Universal Infant Hepatitis B Immunization Strategy: Cost-effectiveness Analysis Based on Markov Model

作　　者：吕秋莹[1] 谢旭[1] 张顺祥[1] 

机构地区：[1]深圳市疾病预防控制中心传染病防制科,广东深圳518055

出　　处：《中国卫生经济》2013年第7期59-61,共3页Chinese Health Economics

基　　金：深圳市科技项目(201002096)

摘　　要：目的:优化深圳市新生儿乙肝免疫预防策略。方法:通过决策树和Markov模型的建立,模拟我市不同乙肝免疫预防策略下2010年新生儿队列感染乙肝病毒及转归,结合我市的参数,运用成本-效果分析评价长期效果。结果:通过现行策略,筛查孕妇HBsAg并给予阳性孕妇的新生儿乙肝疫苗联合HBIG的免疫预防不仅能避免更多的新感染、肝癌和死亡病例的发生,而且获得更多的寿命年和QALYs。从社会角度分析,较现行策略节省40 000 000元。结论:建议深圳政府修改现行新生儿乙肝免疫预防策略,从而获得更大的经济效益和社会效益。Objective： To optimize the Shenzhen universal infant hepatitis B immunization method. Methods： To analyze the long effectiveness of different immunization strategies and disease transition after hepatitis B virus infection by using cost-effectiveness method through decision-tree and Markov models among the Shenzhen newborns cohort in 2010 based on the local parameters. Results： Through the current strategies, the program of screening all pregnant women for HBsAg and vaccinating newborns of single-positive mothers combing with HBIG and vaccine would not only prevent more new cases, hepatic carcinoma and related deaths; but also gain more living years and QALYs. From the social prospect, it will save about RMB 40 million compared with the current program. Conclusion： It is suggested that Shenzhen Government should amend the current universal infant hepatitis B immunization program to gain more economic and social benefits.

关 键 词：乙型病毒性肝炎 免疫策略 决策树模型 MARKOV模型 成本效果分析 

分 类 号：R186[医药卫生—流行病学]