基于真实世界数据缺血性脑卒中神经保护剂类药物治疗效果与经济性评价  

Evaluation of therapeutic efficacy and economics of neuroprotective drugs in treating ischemic stroke based on real-world data

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作  者:刘嘉嘉 罗琼 罗敏[3] 蒋艾豆 吴行伟 邹林珂 胡明[1] LIU Jiajia;LUO Qiong;LUO Min;JIANG Aidou;Wu Xingwei;ZOU Linke;HU Ming(West China School of Pharmacy,Sichuan University,Sichuan Chengdu 610041,China;Department of Equipment,West China Hospital of Stomatology,Sichuan University,Sichuan Chengdu 610041,China;Department of Clinical Pharmacy,West China Hospital of Sichuan University,Sichuan Chengdu 610041,China;Department of Pharmacy,Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital,Sichuan Chengdu 610072,China)

机构地区:[1]四川大学华西药学院,四川成都610041 [2]四川大学华西口腔医院设备部,四川成都610041 [3]四川大学华西医院临床药学部,四川成都610041 [4]四川省医学科学院·四川省人民医院/电子科技大学附属医院药学部,个体化药物治疗四川省重点实验室,四川成都610072

出  处:《中国医院药学杂志》2025年第7期786-791,共6页Chinese Journal of Hospital Pharmacy

基  金:国家重点研发计划项目“主动健康和老龄化科技应对”重点专项“老年常见病多重用药风险管控体系的研究和集成应用示范”项目(编号:2020YFC2005500)。

摘  要:目的:采用真实世界数据对神经保护剂类药物治疗缺血性卒中的有效性和经济性进行评价,为神经保护治疗药物的临床选择和应用提供依据。方法:基于真实世界数据构建回顾性研究队列,根据是否使用神经保护剂类药物设置对照组和干预组,采用倾向评分匹配对混杂因素进行控制。以出院时NIHSS评分、NIHSS评分降幅为有效性指标;以住院总费用、药品费用为经济性指标,对比2组各项指标,分析神经保护剂类药物使用的疗效和经济性。结果:共纳入278例患者,干预组、对照组各139例,干预组、对照组出院时NIHSS评分分别为4.41、4.95分,使用神经保护剂类药物可降低患者出院时NIHSS评分,但差异不具有统计学意义(P=0.9142);经济性方面,干预组的住院总费用、药品费用分别为16258.33、4109.10元,对照组分别为12360.78、1848.71元,差异具有统计学意义(P=0.0189,P=0.0001)。结论:常规药物治疗基础上联用神经保护剂类药物,一定程度上可降低NIHSS评分,但差异无统计学意义,即对支持临床应用的证据不充分,为减轻患者的经济负担、降低医保支出,建议对此类药物使用进行监测。OBJECTIVE To evaluate the efficacy and economics of neuroprotective drugs in treating ischemic stroke based on real-world data,and to provide references for the clinical selection and application of neuroprotective drugs.METHODS A retrospective study cohort was constructed based on real-world data,and grouped based on the use or non-use of neuroprotective drugs.Propensity score matching(PSM)was used to control confounders in the control group and intervention group.The National Institutes of Health Stroke Scale(NIHSS)score at discharge,and reduction of the NIHSS score were used as indicators to evaluate the efficacy of neuroprotective drugs in treating ischemic stroke.Total hospitalization expenses and medication costs were used as indicators to evaluate the economics of neuroprotective drugs in treating ischemic stroke.Indicators were compared between groups to analyze the efficacy and economics of neuroprotective drugs in treating ischemic stroke.RESULTS A total of 278 patients were included,with 139 in the intervention group and 139 in the control group.The NIHSS score at discharge was 4.41 points in the intervention group and 4.95 points in the control group.Use of neuroprotective drugs in treating ischemic stroke significantly decreased the NIHSS scores at discharge,although they were comparable between the intervention and control group(P=0.9142).In terms of the economy,total hospitalization expenses and medication costs were ¥16258.33 and ¥4109.10 in the intervention group,and ¥12360.78 and ¥1848.71 in the control group respectively.There were significant differences in the total hospitalization expenses and medication costs between groups(P=0.0189,and P=0.0001,respectively).CONCLUSION Neuroprotective drugs combined with conventional treatment can reduce the NIHSS scores to a certain extent,but the difference is not statistically significant.The result shows the evidence supporting the clinical application of neuroprotective drugs in treating ischemic stroke is insufficient.It is recommended to strengt

关 键 词:缺血性脑卒中 神经保护剂 治疗效果 经济性评价 

分 类 号:R956[医药卫生—药学]

 

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