阿托西班与利托君治疗孕妇先兆早产的临床疗效与经济学评价  

Clinical Efficacy and Economic Evaluation of Atosiban and Ritodrine in the Treatment of Pregnant Women with Threatened Preterm Birth

作　　者：赵冰封 陈冉 陈红波 孙晓静 许曼 夏涛 黄学桂 ZHAO Bing-Feng;CHEN Ran;CHEN Hong-Bo;SUN Xiao-Jing;XU Man;XIA Tao;HUANG Xue-Gui(Department of Pharmacy,Anhui Maternal and Child Health Hospital,Hefei 230001,China;Department of Obstetrics,Anhui Maternal and Child Health Hospital,Hefei 230001,China;Medical Department,Maternal and Child Health Hospital of Anhui Province,Hefei 230001,China;Department of Science and Education,Anhui Maternal and Child Health Hospital,Hefei 230001,China)

机构地区：[1]安徽省妇幼保健院药学部,合肥230001 [2]安徽省妇幼保健院产一科,合肥230001 [3]安徽省妇幼保健院医务处,合肥230001 [4]安徽省妇幼保健院科教处,合肥230001

出　　处：《中国药物经济学》2024年第5期30-35,41,共7页China Journal of Pharmaceutical Economics

基　　金：安徽省妇幼保健协会科研项目(2020FY12)。

摘　　要：目的 评估阿托西班与利托君治疗先兆早产的临床疗效及经济性。方法 回顾性调查安徽省妇幼保健院2020年1月至2022年12月住院患者信息,纳入17~42岁且孕期介于24~33周的先兆早产孕妇共66例,接受阿托西班或利托君治疗孕妇分别为23例与43例,评价两组用药有效性。从医疗机构的角度收集两组直接医疗成本数据,以2022年人民币币值为基准,按5%贴现率对费用数据进行折现,计算平均成本与组间差异。按最小成本分析法评价其经济性,并通过敏感性分析评价研究结果的稳健性。结果 两组孕妇保胎成功率、住院48 h内分娩率、住院后48 h至7 d分娩率及延长妊娠时间比较差异无统计学意义(P>0.05);两组早产儿出生时胎龄、体重、Apgar评分(1 min与5 min)、住院时程、入住新生儿重症监护病房(NICU)天数、持续气道正压通气(CPAP)时间及脑损伤、败血症与视网膜病变发生率比较差异无统计学意义(P>0.05);最小成本分析结果显示,阿托西班用药组家庭住院平均费用比利托君组高23588.5元,即利托君更具有经济学优势;敏感性分析结果显示,随着贴现率上下浮动8%,或纳入孕妇孕期按是否达到30周进行分层统计时,阿托西班组家庭住院费用均高于利托君组,评价结果均未改变。结论 利托君治疗先兆早产较阿托西班的成本更低,且疗效相近。Objective To evaluate the clinical efficacy and economics of Atosiban and Ritodrine in the treatment of threatened preterm birth.Methods A total of 66 pregnant women with threatened preterm delivery aged 17~42 years and between 24~33 weeks of gestation were included.23 and 43 pregnant women were treated with Atosiban or Ritodrine,respectively,to evaluate the effectiveness of the two groups.Two sets of direct medical cost data were collected from the perspective of medical institutions.Based on the 2022 RMB currency value,the cost data were discounted at a 5% discount rate to calculate the average cost and the difference between groups.The economy was evaluated according to the minimum cost analysis method,and the robustness of the research results was evaluated by sensitivity analysis.Results There were no significant differences in the success rate of pregnancy preservation,delivery rate within 48 h after hospitalization,delivery rate 48 h to 7 d after hospitalization and extended gestation time between the two groups(P>0.05).There were no significant differences in gestational age,body weight,Apgar score(1 min vs.5 min),length of hospitalization,length of stay in neonatal intensive care unit(NICU),duration of continuous positive airway pressure(CPAP),incidence of brain injury,septicemia and retinopathy between the two groups(P>0.05).The results of minimum cost analysis showed that the average hospitalization cost of Atosiban group was 23588.5 yuan higher than that of Ritodrine group,indicating that Ritodrine had more economic advantages.Sensitivity analysis results showed that with the discount rate floating up and down by 8%,or when the patients were included in the stratized statistics according to whether they reached 30 weeks of pregnancy,the family hospitalization costs of Atosiban group were higher than those of Ritodrine group,and the evaluation results were unchanged.Conclusion The cost of Ritodrine is lower than that of Atosiban in the treatment of threatened preterm birth,and the efficacy is similar.

关 键 词：先兆早产 阿托西班 利托君 最小成本分析法 宫缩抑制剂 

分 类 号：R714.4[医药卫生—妇产科学] R956[医药卫生—临床医学]