关于冠心病患者PCI术后双心治疗成本-效果比的临床研究  

A Clinical Study on the Cost-Effectiveness of Psycho-Cardiological Therapy in Patients with Coronary Artery Disease Post PCI

作　　者：何东方[1] 张丽军[1] 迟云鹏[1] 李果[1] 鲁楠 张瑜[1] 李艳玮 王森 黄晓蓉[1,3] 潘若愚 鲍彦平 刘梅颜[1] HE Dongfang;ZHANG Lijun;CHI Yunpeng;LI Guo;LU Nan;ZHANG Yu;LI Yanwei;WANG Sen;HUANG Xiaorong;PAN Ruoyu;BAO Yanping;LIU Meiyan(Department of Psycho-Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;School of Clinical Medicine,He’nan University,Kaifeng He’nan 475001,China;Department of Cardiology,Second Hospital of Shanxi Medical University,Taiyuan Shanxi 030000,China;Department of Internal Medicine,University Hospital,Beijing Information Science and Technology University,Beijing 100192,China;Department of Epidemiology,National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence,Peking University,Beijing 100191,China;Department of Epidemiology&Biostatistics,School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]首都医科大学附属北京安贞医院双心医学中心,北京100029 [2]河南大学临床医学院,河南开封475001 [3]山西医科大学第二医院心内科,山西太原030000 [4]北京信息科技大学校医院内科,北京100192 [5]北京大学中国药物依赖性研究所流行病室/药物依赖性研究北京市重点实验室,北京100191 [6]北京大学公共卫生学院流行病与卫生统计学系,北京100191

出　　处：《中国卫生标准管理》2023年第15期68-73,共6页China Health Standard Management

摘　　要：目的比较冠心病(coronary artery disease,CAD)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后双心治疗与常规治疗的成本-效果,为冠心病患者PCI术后双心治疗提供依据。方法共纳入2021年8月—2023年6月于首都医科大学附属北京安贞医院住院行PCI手术治疗的195例CAD患者,随机分为双心治疗组(79例)与常规治疗组(116例)。通过2周,1、3、6、12、18个月随访,比较两种治疗方法的疗效,计算成本-效果比(cost-effectiveness ratio,CER)、增量成本-效果比(incremental cost-effectiveness ratio,ICER)。结果双心治疗组共79例,其中1例因急性冠脉综合征(acute coronary syndrome,ACS)再入院行PCI治疗,有效率为98.73%;常规治疗组116例,10例因ACS再入院,7例行PCI治疗,1例行冠脉造影检查,2例保守治疗,有效率为91.38%,双心治疗组的临床有效率明显高于常规治疗组(P=0.028)。常规治疗组的CER为766.74,双心治疗组CER为713.44,双心治疗的CER显著低于常规治疗。ICER为50.86。结论与常规治疗比较,冠心病患者PCI术后双心治疗有更显著的临床疗效,较低的CER,且有更好的卫生经济学价值。Objective To analyze the cost-effectiveness(CE)of psycho-cardiological therapy in coronary artery disease(CAD)patients post percutaneous coronary intervention(PCI),in order to provide scientific economic basis for psychocardiological therapy.Methods A total of 195 patients with CAD post PCI in Beijing Anzhen Hospital,Capital Medical University,from August 2021 to June 2023 were included and were randomly assigned to psycho-cardiological treatment group and regular treatment group,after following up for 2 weeks,1 month,3 months,6 months,12 months,and 18 months.Then the cost-effectiveness ratio(CER),and incremental cost-effectiveness ratio(ICER)were analyzed.Results There were 79 patients in the dual-heart treatment group,one of whom was readmitted to hospital for PCI due to acute coronary syndrome(ACS),and the effective rate was 98.73%.While in the regular treatment group,among the 116 patients,10 patients were re-admitted to hospital for ACS.Meanwhile,among the 10 patients,7 patients received PCI treatment,1 patient received coronary angiography(CAG),the other 2 patients received conservative treatment.And total effective rate of the regular treatment group was 91.38%.the psychocardiological treatment group had significant higher total effective rate than the regular treatment group(P=0.028).The psychocardiological treatment presented significant lower CER than the regular treatment(713.44 vs.766.74).The ICER was 50.86.Conclusion There is higher total effective rate and lower CER after psycho-cardiological treatment.Moreover,this study provides scientific medical economic basis for psycho-cardiological therapy.

关 键 词：PCI术 冠心病 双心治疗 卫生经济学 成本-效果比 增量成本-效果比 

分 类 号：R541[医药卫生—心血管疾病]