运用决策树模型对国产和进口万古霉素治疗耐甲氧西林金黄色葡萄球菌颅内感染进行成本-效果分析  

Cost-effectiveness Analysis of Domestic and Imported Vancomycin in the Treatment of Intracranial Infection Induced by MRSA by Using Decision Tree Model

作　　者：黄春[1] 莫凡露 秦幸楠 张宏亮[1] HUANG Chun;MO Fanlu;QIN Xingnan;ZHANG Hongliang(Dept. of Pharmacy,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院药学部,南宁530021

出　　处：《中国药房》2019年第9期1256-1259,共4页China Pharmacy

基　　金：广西自然科学基金资助项目(No.2017GXNSFBA198177);广西高校中青年教师基础能力提升项目(No.KY2016YB098);广西研究生教育创新计划项目(No.YCBZ2017043)

摘　　要：目的:分析国产注射用盐酸万古霉素(商品名:来可信)和进口注射用盐酸万古霉素(商品名:稳可信)治疗耐甲氧西林金黄色葡萄球菌(MRSA)颅内感染的有效性和经济性,为临床药物选择提供决策依据。方法:采用回顾性研究方法,收集2016年1月-2017年6月我院神经外科MRSA颅内感染并使用来可信或稳可信治疗的患者病例资料,其中来可信115例,稳可信42例,以有效率(包括临床治愈和临床好转)为效果指标,运用决策树模型对来可信和稳可信治疗MRSA颅内感染进行成本-效果分析,分别以成本下降10%和有效率下降10%进行敏感性分析。结果:来可信的有效率为85.21%,期望成本为13 125.96元,成本-效果比(CER)为15 404.25;稳可信的有效率为78.57%,期望成本为15 619.17元,CER为19 879.31,来可信与稳可信治疗MRSA颅内感染的有效率比较差异无统计学意义(P<0.05)。敏感性分析结果与成本-效果分析结果无差异。结论:来可信和稳可信治疗MRSA颅内感染的有效性相当,但来可信的CER低于稳可信的CER。OBJECTIVE:To analyze effectiveness and economy of domestic vancomycin hydrochloride for injection (trade name:Laikexin)vs. imported vancomycin hydrochloride for injection(trade name:Vancocin)in treatment of intracranial infection induced by MRSA,and to provide decision-making reference for the selection of clinical drugs. METHODS:Clinical data of patients with suspected MRSA intracranial infections receiving Laikexin or Vancocin were collected by retrospective study method from neurosurgery department of our hospital during Jan. 2016 to Jun. 2017,including 115 cases of Laikexin and 42 cases of Vancocin. Using response rate (including clinical cure and clinical improvement) as indexes,cost-effectiveness analysis was performed for Laikexin and Vancocin in the treatment of intracranial infection induced by MRSA by using decision tree model. Sensitivity analysis was conducted for 10% decrease of cost and response rate. RESULTS:Response rate and excepted cost of Laikexin were 85.21% and 13 125.96 yuan,cost-effectiveness ratio(CER)was 15 404.25. Response rate and excepted cost of Vancocin were 78.57% and 15 619.17 yuan,CER was 19 879.31. There was no statistical significance in response rate between Laikexin and Vancocin (P<0.05). There was no difference between sensitivity analysis and cost-effectiveness analysis. CONCLUSIONS:The efficacy of Laikexin and Vancocin in the treatment of MRSA intracranial infection is similar,but the CER of Laikexin is lower than that of Wenkexin.

关 键 词：决策树模型 来可信 稳可信 耐甲氧西林金黄色葡萄球菌颅内感染 成本-效果比 

分 类 号：R956[医药卫生—药学]