替诺福韦酯与替比夫定用于乙型肝炎母婴阻断有效性及经济性比较  

Efficacy and Economic Comparison of Tenofovir Dipivoxil and Telbivudine in Blocking Mother-to-Child Transmission of Hepatitis B

作　　者：王超[1] 郭立杰[1] 修宪 张玉君 张海丛[1] 冯彩霞[1] WANG Chao;CUO Lijie;XIU Xian;ZHANG Yujun;ZHANG Haicong;FENG Caixia(The Fifth Hospital of Shijiazhuang,Shijiazhuang,Hebei,China 050021;The Second Hospital of Shijiazhuang,Shijiazhuang,Hebei,China 050051)

机构地区：[1]河北省石家庄市第五医院,河北石家庄050021 [2]河北省石家庄市第二医院,河北石家庄050051

出　　处：《中国药业》2020年第15期93-96,共4页China Pharmaceuticals

基　　金：河北省石家庄市科学技术研究与发展指导计划项目[181200943]。

摘　　要：目的比较替诺福韦酯和替比夫定阻断乙肝母婴传播的有效性和经济性。方法选择医院2017年1月至2018年12月收治的慢性乙型肝炎、乙型肝炎病毒(HBV)DNA载量≥2×106 U/m L的妊娠患者206例,均于妊娠第24~28周给予抗病毒治疗,产后停药。根据给予药物的不同分为替诺福韦酯(进口)组(A组)、替诺福韦酯(国产)组(B组)和替比夫定组(C组)。比较3组抗病毒药物阻断乙肝母婴传播的有效性;对患者的治疗费用(药品费用、检查费用、住院费用)进行回顾性统计与分析,比较3组的经济性。结果A组和B组乙肝母婴阻断成功率均为100.00%,C组为98.72%;A组和B组HBV DNA载量降低程度及阴转率均优于C组(P<0.05)。A组和B组的成本-效果比(CEA)均小于C组,且增量成本-效果比均为负值,均为优势方案;B组CEA最低,经济性优于A组。结论替诺福韦酯比替比夫定具有更高的乙肝母婴阻断成功率及更好的经济性;国产替诺福韦酯CEA最低,建议临床优先选用。Objective To compare the efficacy and economy of tenofovir dipivoxil and telbivudine in blocking mother-to-child transmission of hepatitis B.Methods A total of 206 pregnant women with chronic hepatitis B and hepatitis B virus(HBV)DNA≥2×106 IU/m L in the hospital from January 2017 to December 2018 were collected.Antiviral therapy was given at the 24 th to 28 th week of pregnancy,and withdrawal after delivery.According to the different drugs,the patients were divided into the imported tenofovir dipivoxil group(group A),domestic tenofovir dipivoxil group(group B),and telbivudine group(group C).The clinical data of these patients and their newborns were collected to compare the effectiveness of the three groups of antiviral drugs in blocking mother-to-child transmission of hepatitis B.A retrospective statistical analysis on the costs of patients’treatment(drugs,examinations and hospitalization)was conducted to compare the economic benefits of the three groups.Results The success rate for blocking mother-to-child transmission of hepatitis B in groups A,B were both 100.00%,and group C was 98.72%.The reduction of HBV DNA load and negative rate in groups A,B were significantly better than group C(P<0.05).The cost-effectiveness ratio(CEA)in groups A,B was both lower than that of group C,and the incremental cost-effectiveness ratio(ICER)were both negative,indicating both were superior schemes.Group B had the lowest CEA,and its economy was better than that of group A.Conclusion Tenofovir dipivoxil has a higher success rate in blocking mother-to-child transmission of hepatitis B and has a better economy.In particular,domestic tenofovir dipivoxil has the lowest cost-effectiveness ratio,so it is recommended that it be used preferentially in the clinic.

关 键 词：乙型肝炎病毒 母婴阻断 替诺福韦酯 替比夫定 有效性 经济性 

分 类 号：R969.4[医药卫生—药理学] R956[医药卫生—药学]