集中招标采购药品用于缺血性卒中二级预防1年横断面研究  

A Cross-Section Study of Pharmaceutical Centralized Procurement Drugs for the Secondary Prevention of Ischemic Stroke for a Year

作　　者：展宏刚 吴传亮 庄勤武 仲晓荣 刘钒 ZHAN Honggang;WU Chuanliang;ZHUANG Qinwu;ZHONG Xiaorong;LIU Fan(Taishan Hospital of Shandong Province,Tai′an,Shandong,China 271000;Tai′an 88th Hospital of Shandong Province,Tai′an,Shandong,China 271000;The Second Rehabilitation Hospital of Shandong Province,Tai′an,Shandong,China 271000)

机构地区：[1]山东省泰山医院,山东泰安271000 [2]山东省泰安八十八医院,山东泰安271000 [3]山东省第二康复医院,山东泰安271000

出　　处：《中国药业》2025年第5期111-114,共4页China Pharmaceuticals

摘　　要：目的 比较集中招标采购(简称集采)药品与非集采药品对缺血性卒中二级预防的效果。方法 选取2020年7月至2022年10月在山东省第二康复医院、山东省泰山医院、山东省泰安八十八医院接受治疗的初发缺血性卒中且出院后用药实施二级预防并定期复诊的患者为研究对象。根据是否使用集采药品,初发缺血性卒中患者被分为集采组(用集采药品实施二级预防)和非集采组(用非集采药品实施二级预防),按美国国立卫生研究院卒中量表(NIHSS)相近的原则配对,两组各397例,以实施二级预防1年为时间节点,比较两组患者的用药疗效、药品不良反应(ADR)、用药成本、成本-效果比、卒中复发率;取1年内缺血性卒中复发的全部125例为观察组,配对未复发的125例为对照组,用病例对照研究确定卒中复发的危险因素。结果 两组患者的二级预防疗效和卒中复发率均无显著差异(P> 0.05),但集采组发生体位性低血压的比率较高(22.42%比16.62%,P=0.039),全年用药成本低于非集采组(P=0.042),前6个月成本-效果比优于非集采组(P=0.046)。Logistic多因素分析结果表明,缺血性卒中1年内复发与年龄增加[OR=3.06,95%CI(1.78,8.01),P=0.030],脑血管病-05-缺血性脑卒中病因分型(TOAST分型)中的大动脉硬化[OR=3.95,95%CI(1.49,7.02),P=0.023]相关;但与体位性低血压(P=0.114),是否使用集采药品(P=0.219),平均用药成本(P=0.110),成本-效果比(P=0.170)无关。结论 使用集采药品实施二级预防的有效性与非集采药品相当,且使用集采药品实施缺血性卒中二级预防的全年成本和前6个月成本-效果比优于非集采药品。Objective To compare the effect of pharmaceutical centralized procurement(PCP)and non-PCP drugs on the secondary prevention of ischemic stroke.Methods From July 2020 to October 2022,the patients with initial ischemic stroke who were treated in the Second Rehabilitation Hospital of Shandong Province,Taishan Hospital of Shandong Province,and Tai′an 88th Hospital of Shandong Province,and who took secondary prevention drugs after discharge and regularly returned to the hospital were selected as the research objects.According to whether or not to use PCP drugs,patients with newly diagnosed ischemic stroke were divided into the PCP group(using PCP drugs for secondary prevention)and the non-PCP group(using non-PCP drugs for secondary prevention).They were matched according to the principle of similar National Institutes of Health Stroke Scale(NIHSS)score pairing,with 397 cases in each group.The medication efficacy,adverse drug reactions(ADRs),medication cost,cost-effectiveness ratio,and stroke recurrence rate in the two groups were compared with a one-year implementation of secondary prevention as the time node.All 125 cases with ischemic stroke recurrence within one year were selected as the observation group,and 125 cases without recurrence were paired as the control group.A case-control study was conducted to determine the risk factors for stroke recurrence.Results There was no significant difference in the efficacy of secondary prevention and stroke recurrence rate between the two groups(P>0.05),but the incidence of orthostatic hypotension in the PCP group was higher than that in the non-PCP group(22.42%vs.16.62%,P=0.039),the annual medication cost in the PCP group was lower than that in the non-PCP group(P=0.042),and the cost-effectiveness ratio in the first six months in the PCP group was better than that in the non-PCP group(P=0.046).Logistic multivariate analysis results showed that the recurrence of ischemic stroke within one year was associated with increased age[OR=3.06,95%CI(1.78,8.01),P=0.030],and large a

关 键 词：药品集中招标采购 缺血性卒中 二级预防 成本-效果分析 横断面研究 

分 类 号：R95[医药卫生—药学]