戊乙奎醚与阿托品治疗急性有机磷中毒的药物经济学分析
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篇名: 戊乙奎醚与阿托品治疗急性有机磷中毒的药物经济学分析
TITLE:
摘要: 目的:评价戊乙奎醚与阿托品治疗急性有机磷农药中毒(AOPP)的经济性。方法:收集118例AOPP患者资料,按治疗方案的不同分为A组(59例)和B组(59例),其中A组轻度22例、中度20例、重度17例;B组轻度21例、中度21例、重度17例。在常规治疗的基础上,A 组患者肌内注射盐酸戊乙奎醚注射液首次剂量1 mg(轻度)、2 mg(中度)、 4 mg(重度),B 组患者静脉注射硫酸阿托品注射液首次剂量2 mg(轻度)、5 mg(中度)、10 mg(重度),两组均视情况给予维持治疗待症状消失后停药。观察两组患者的临床疗效,乙酰胆碱酯酶恢复时间及不良反应发生情况。采用成本-效果分析方法评定两组轻、中、重度患者用药方案的经济性。结果:两组轻度中毒患者总有效率、乙酰胆碱酯酶恢复时间比较,差异均无统计学意义(P>0.05)。A组中、重度中毒患者总有效率均显著高于B组,乙酰胆碱酯酶恢复时间均显著短于B组,差异均有统计学意义(P<0.05)。两组轻、中、重度患者不良反应发生率比较,差异均无统计学意义(P>0.05)。轻度中毒患者,戊乙奎醚与阿托品的成本-效果比相当;中、重度中毒患者,戊乙奎醚的成本-效果比均显著低于阿托品。敏感度分析结果与一致。结论:在常规治疗的基础上,戊乙奎醚与阿托品治疗轻度AOPP患者的疗效、乙酰胆碱酯酶恢复时间均相当,对于中、重度AOPP患者戊乙奎醚在提高疗效、改善乙酰胆碱酯酶恢复时间方面均显著优于阿托品,且两种用药方案的安全性均较好。戊乙奎醚治疗中、重度AOPP患者具有成本效果优势。
ABSTRACT: OBJECTIVE: To evaluate the economics of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus poisoning (AOPP). METHODS: The information of 118 AOPP patients were collected and divided into group A (59 cases) and B (59 cases) according to therapy plan. There were 22 cases of mild poisoning, 20 cases of moderate poisoning and 17 cases of severe poisoning in group A. There were 21 mild cases , 21 moderate cases and 17 severe cases in group B. Based on routine treatment, group A was given Penehyclidine hydrochloride injection intramuscularly with initial dose of 1 mg (mild), 2 mg (moderate) and 4 mg (severe). Group B was given Atropine sulfate injection intravenously, with initial dose of 2 mg (mild), 5 mg (moderate) and 10 mg (severe). Both received maintenance treatment according to patients condition and stopped taking medicine after symptoms disappeared. Clinical efficacies, the time of acetylcholinesterase recovery and ADR were observed in 2 groups. The economics of therapy plans for mild, moderate and severe poisoning were evaluated in 2 groups by cost-effectiveness analysis. RESULTS: There was no statistical significance in total response rate of mild poisoning or the time of acetylcholinesterase recovery between 2 groups (P>0.05). Total effective rates of moderate and severe poisoning in group A were significantly higher than group B, and the time of acetylcholinesterase recovery was significantly shorter than group B, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR in mild, moderate and severe poisoning patients (P>0.05). Cost-effectiveness ratio of penehyclidine hydrochloride was similar to that of atropine in mild poisoning patients; that of penehyclidine hydrochloride were significantly lower than that of atropine in moderate and severe patients. It was inline with the results of sensitivity analysis. CONCLUSIONS: Based on routine treatment, penehyclidine hydrochloride is similar to atropine in therapeutic efficacy of AOPP and the time of acetylcholinesterase recovery. For moderate and severe AOPP patients, penehyclidine hydrochloride is significantly better than atropine in improving therapeutic efficacy and the time of acetylcholinesterase recovery. The safety of 2 drugs are satisfactory; penehyclidine hydrochloride possesses cost-effectiveness advantage.
期刊: 2017年第28卷第24期
作者: 赵池,邓晓琴,李永平
AUTHORS: ZHAO Chi,DENG Xiaoqin,LI Yongping
关键字: 戊乙奎醚;阿托品;急性有机磷农药中毒;成本-效果分析
KEYWORDS: Penehyclidine hydrochloride; Atropine; Acute organophosphorus poisoning; Cost-effectiveness analysis
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