3种不同方案治疗HIV/TB感染患者抗结核药物性肝损伤的成本-效果分析

目的:探讨3种不同治疗方案用于治疗人类免疫缺陷病毒合并结核杆菌(HIV/TB)感染患者抗结核药物性肝损伤的成本与效果。方法:将213例患者随机均分成A、B、C组,A组应用还原型谷胱甘肽静脉滴注+口服序贯治疗,B组应用复方甘草酸苷静脉滴注+口服序贯治疗,C组应用还原型谷胱甘肽静脉滴注+复方甘草酸苷口服序贯治疗,观察3组疗效和不良反应,并运用药物经济学方法分析其成本-效果。结果:3种药物治疗方案成本分别为1221.0、1076.5、960.7元(P>0.05);有效率分别为94.4%、85.9%、90.1%(P>0.05);不良反应发生率分别为50.7%、40.8%、43.7%(P>0.05);成本-效果比分别为12.9、12.5、10.7(P<0.05)。结论:与A、B方案比较,C方案治疗HIV/TB感染患者抗结核药物性肝损伤疗效相当,但经济性较好。

Cost-effectiveness Analysis of 3 Different Schemes in the Treatment of Antituberculosis Drug-induced Hepa- totoxicity in HIV/TB Patients

OBJECTIVE： To probe into the cost-effectiveness of 3 different therapeutic schemes in the treatment of antitubercu-losis drug-induced hepatotoxicity in HIV/TB patients. METHODS： 213 patients were randomly divide into 3 groups, including group A was given sequential therapy of reduced glutathione, group B sequential therapy of Compound glycyrrhizin and group C sequential therapy of intravenous dripping of reduced glutathione and oral dose of Compound glycyrrhizin. Therapeutic efficacies and adverse drug reactions were observed in 3 groups, and cost-effectiveness of 3 schemes were analyzed by pharmacoeconomics. RE- SULTS： The costs for the 3 treatment schemes were 1 221.0 yuan, 1 076.5 yuan and 960.7 yuan respectively; the incidences of ad- verse drug reactions were 50.7%, 40.8% and 43.7%respectively（P〉0.05） ; the effective rates were 94.4%, 85.9% and 90.1% （P〉0.05）, respectively; there was no significant difference in the effective rates of 3 therapeutic schemes in the treatment of antitu- berculosis drug-induced hepatotoxicity in HIV/TB patients （P〉0.05） ; the cost-effectiveness ratio were 12.9, 12.5 and 10.7 （P〈 0.05）. CONCLUSION： Compared with scheme A and scheme B, schemes C is the preferable one for drug-induced hepatic injury in HIV/TB patients.