缬沙坦治疗慢性肾脏病合并高血压的meta分析及药物经济学评价  

Meta-analysis and Pharmacoeconomics Evaluation of Valsartan in the Treatment of Chronic Kidney Disease with Hypertension

作　　者：刘俏[1,2] 许清青 郑绘[4] 易利丹[1,2] 罗霞[1,2] LIU Qiao;XU Qingqing;ZHENG Hui;YI Lidan;LUO Xia(Department of Pharmacy,the Second Xiangya Hospital of Central South University,Changsha 410011,China;Institute of Clinical Pharmacy,Central South University,Changsha 410011,China;Central South University School of Public Administration,Changsha 410002,China;Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]中南大学湘雅二医院药学部,长沙410011 [2]中南大学临床药学研究所,长沙410011 [3]中南大学公共管理学院,长沙410002 [4]成都中医药大学附属医院,成都610075

出　　处：《中国现代应用药学》2025年第1期124-129,共6页Chinese Journal of Modern Applied Pharmacy

基　　金：湖南省卫生健康委科研计划项目(202113050611、202213053462);湖南省自然科学基金(2021JJ40817、2022JJ80040)。

摘　　要：目的基于meta分析研究缬沙坦治疗慢性肾脏病合并高血压的有效性与安全性,以及开展药物经济学研究,为合理用药提供指导,同时为相关医疗卫生决策提供证据。方法计算机检索PubMed、Embase、The Cochrane Library、中国知网、万方、维普等数据库关于缬沙坦治疗慢性肾脏病合并高血压的文献资料,对其有效性和安全性进行meta分析,并采用增量成本效果比(incremental cost-effectiveness ratio,ICER)进行经济学评价,同时进行敏感性分析。结果共纳入有效文献8篇,包括1586例患者。Meta分析结果显示,相较于硝苯地平控释片单药,缬沙坦联合硝苯地平控释片能改善SBP、DBP和UAER,减少不良反应,且差异均有统计学意义(P<0.01)。从卫生体系角度出发,以血压值、UAER值和降压有效率为效果指标,药物经济学分析结果显示缬沙坦单药或联合硝苯地平控释片与其他方案比较,ICER<1倍人均可支配收入或效果更佳的同时成本更低。敏感性分析结果与基础分析结果基本一致。结论缬沙坦单药或联合硝苯地平控释片相较于其他药物方案在慢性肾脏病合并高血压治疗中有效性和经济性具有一定优势,且使用缬沙坦联合治疗不良反应发生率降低,安全性更高。但受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。OBJECTIVE To study the efficacy and safety of valsartan in the treatment of chronic kidney disease complicated with hypertension based on meta-analysis,and to conduct pharmacoeconomic research,so as to provide guidance for rational drug use and provide evidence for making relevant healthcare decisions.METHODS PubMed,Embase,The Cochrane Library,CNKI,Wanfang,Weipu and other databases were searched to collect literature on valsartan in the treatment of chronic kidney disease complicated with hypertension,then meta-analysis was conducted,and the incremental cost-effectiveness ratio(ICER)was used for economic evaluation,and sensitivity analysis were performed.RESULTS A total of 8 valid literatures including 1586 patients were included.Meta-analysis showed that valsartan in combination with nifedipine controlled release tablets improved the measures SBP,DBP and UAER,and decreased adverse effects,and the differences were statistically significant(P<0.01),when compared to nifedipine controlled release tablets alone.From the health system perspective,and using the blood pressure value,UAER value,and blood pressure reduction efficiency as the effectiveness indicators,the results of the pharmacoeconomics evaluation showed that valsartan alone or in combination with nifedipine controlled release tablets had an ICER of less than one times per capita disposable income or had better effectiveness with lower costs when compared to other regimens.The results of the sensitivity analysis were basically consistent with the results of the basic analysis.CONCLUSION Compared with other drug regimens,valsartan alone or in combination with nifedipine controlled release tablets has certain advantages in efficacy and economy in the treatment of chronic kidney disease and hypertension,and the probability of adverse reactions caused by the combination treatment of valsartan is decreased and the safety is higher.However,due to limitations in the number and quality of included studies,these conclusions need to be validated by more high-quality

关 键 词：缬沙坦 慢性肾脏病 高血压 效果 经济性 

分 类 号：R969.3[医药卫生—药理学]