帕拉米韦与奥司他韦治疗儿童流感病毒肺炎的成本-效果分析  

Cost-effectiveness analysis of peramivir and oseltamivir in treatment of influenza virus pneumonia in children

作　　者：陈圣洁[1] 戴兰芬[2] 李丹丹 王乐[3] 李成玲[1] 蒋春颖 Chen Shengfie;Dai Lanfen;Li Dandan;Wang Le;Li Chengling;Jiang Chunying(Department of Pharmacy,Children's Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Respiratory Medicine,Children's Hospital of Hebei Province,Shijiazhuang 050031,China;Institute of Pediatrics,Children's Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Heahh Care.People's Hospital of Gu'an County,Hebei Province,Langfang 065500,China)

机构地区：[1]河北省儿童医院药剂科,石家庄050031 [2]河北省儿童医院呼吸科,石家庄050031 [3]河北省儿童医院儿科研究所,石家庄050031 [4]河北省廊坊市固安县人民医院医保科,065500

出　　处：《中国医药》2019年第2期215-218,共4页China Medicine

基　　金：河北省卫生和计划生育委员会医学科学研究重点课题计划(20170391)~~

摘　　要：目的分析帕拉米韦与奥司他韦治疗儿童流感病毒肺炎的成本及效果。方法选取2017年2月至2018年2月河北省儿童医院收治的98例儿童流感病毒肺炎患者,按照随机数表法分为A组和B组,每组49例。A组采用帕拉米韦氯化钠注射液静脉滴注治疗,B组采用磷酸奥司他韦颗粒口服治疗,按照体质量给药。比较2组患儿的临床疗效、治疗后的症状体征改善时间和用药时间以及住院时间,计算用药成本,并比较2组不良反应的发生情况。结果 A组和B组治疗总有效率比较[91. 8%(45/49)比85. 7%(42/49)],差异无统计学意义(P=0. 337)。A组患儿体温下降、体温恢复、咳嗽消失、肺部啰音消失时间以及用药时间、住院时间均明显短于对照组[(1. 4±0. 5) d比(2. 5±0. 6) d、(2. 7±0. 9) d比(4. 8±1. 4) d、(9. 0±1. 3) d比(11. 5±1. 8) d、(6. 6±0. 8) d比(10. 8±1. 8) d、(3. 0±0. 5) d比(4. 5±1. 1) d、(7. 8±1. 6) d比(12. 8±1. 9) d](均P <0. 001)。A组用药成本明显高于B组[(686±128)元比(158±25)元](P <0. 001)。A组和B组药物不良反应发生率比较,差异无统计学意义(P=0. 766)。结论帕拉米韦与奥司他韦治疗儿童流感病毒肺炎的疗效相当,且均具有较好的安全性。但与奥司他韦相比,帕拉米韦治疗可更加有效地促进临床症状体征改善,缩短用药及住院时间,但用药成本较高。Objective To analyze the costs and effectiveness of peramivir and oseltamivir in the treatment of influenza virus pneumonia in children. Methods Between February 2017 and February 2018, 98 children with influenza virus pneumonia were enrolled in Children′s Hospital of Hebei Province. They were randomly divided into group A and group B, with 49 cases in each group. The group A was treated with intravenous peramivir and the group B took oseltamivir. Clinical effectiveness, recovery time of symptoms and signs, medication duration and hospital stay time, cost of drugs and incidence of adverse reactions were analyzed. Results There was no significant difference of the total effective rate between the group A and group B[91.8%(45/49) vs 85.7%(42/49)](P=0.337). Body temperature drop time, body temperature recovery time, cough disappearing time, lung rales disappearing time, medication duration and hospital stay time in the group A were significantly shorter than those in the group B[(1.4±0.5)d vs (2.5±0.6)d, (2.7±0.9)d vs (4.8±1.4)d, (9.0±1.3)d vs (11.5±1.8)d, (6.6±0.8)d vs (10.8±1.8)d, (3.0±0.5)d vs (4.5±1.1)d, (7.8±1.6)d vs (12.8±1.9)d](P<0.001). Cost of drugs in the group A was significantly higher than that in the group B[(686±128)yuan vs (158±25)yuan](P<0.001). Incidence of adverse reactions showed no significant difference between the two groups(P=0.766). Conclusions Peramivir and oseltamivir show similar efficacy and good safety in the treatment of influenza virus pneumonia in children. Peramivir is effective in improving clinical symptoms and reducing lengths of medication and hospital stay, but the cost is relatively high.

关 键 词：流感病毒肺炎 帕拉米韦 奥司他韦 成本-效果分析 

分 类 号：R563.1[医药卫生—呼吸系统]