3种质子泵抑制药预防颈脊髓损伤患者应激性溃疡的最小成本分析
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摘要
目的:评价3种质子泵抑制药预防颈脊髓损伤(CSCI)患者应激性溃疡(SU)的临床效果、不良反应(ADR)与成本。方法:采用回顾性分析方法,选取我院2018年1～6月收治的CSCI患者131例,按用药方案不同分为3组,分别为泮托拉唑钠80 mg,ivd,qd、奥美拉唑钠40 mg,ivd,qd、兰索拉唑30 mg,ivd,bid。观察3组方案预防患者消化道出血的疗效、不良反应发生情况,并评价3种质子泵抑制药的经济性。结果:泮托拉唑、奥美拉唑、兰索拉唑预防CSCI患者SU的有效率依次为93. 2%,93. 8%,97. 4%,不良反应发生率依次为6. 8%,6. 2%,5. 1%,差异均无统计学意义(P> 0. 05)。以最小成本分析进行药物经济学评价,3种质子泵抑制药预防CSCI患者SU的经济性由高到低依次为泮托拉唑、奥美拉唑、兰索拉唑。结论:泮托拉唑、奥美拉唑和兰索拉唑预防CSCI患者SU的疗效和安全性均较好,但相较于其他两种药物,泮托拉唑经济性更优,临床医师可根据患者情况选择用药。
Objective: To compare the clinical efficacy,ADR and cost of 3 PPIs in the prevention of stress ulcer( SU) after cervical spinal cord injury( CSCI). Methods: In a retrospective study,131 CSCI patients were selected from our hospital during January and June 2018,and then divided into 3 groups according to their medication. The patients were treated with pantoprazole( 80 mg,ivd,qd),omeprazole( 40 mg,ivd,qd) and lansoprazole( 30 mg,ivd,bid),respectively. The clinical efficacy,adverse drug reactions and economics were compared among the 3 groups. Results: The effective rate of pantoprazole,omeprazole and lansoprazole in preventing SU in the patients with CSCI was 93. 2%,93. 8% and 97. 4%,and the incidence of adverse reactions was 6. 8%,6. 2% and5. 1%,respectively without statistical significance( P > 0. 05). Taking the minimum cost analysis as the pharmacoeconomic evaluation,the economical efficiency of the 3 PPIs in preventing SU in the patients with CSCI from high to low order was pantoprazole,omeprazole and lansoprazole. Conclusion: Pantoprazole,omeprazole and lansoprazole all show good effectiveness and safety in the prevention of SU,while pantoprazole is more economical than the others,and clinicians may choose drugs according to patient's conditions.
Objective: To compare the clinical efficacy,ADR and cost of 3 PPIs in the prevention of stress ulcer( SU) after cervical spinal cord injury( CSCI). Methods: In a retrospective study,131 CSCI patients were selected from our hospital during January and June 2018,and then divided into 3 groups according to their medication. The patients were treated with pantoprazole( 80 mg,ivd,qd),omeprazole( 40 mg,ivd,qd) and lansoprazole( 30 mg,ivd,bid),respectively. The clinical efficacy,adverse drug reactions and economics were compared among the 3 groups. Results: The effective rate of pantoprazole,omeprazole and lansoprazole in preventing SU in the patients with CSCI was 93. 2%,93. 8% and 97. 4%,and the incidence of adverse reactions was 6. 8%,6. 2% and5. 1%,respectively without statistical significance( P > 0. 05). Taking the minimum cost analysis as the pharmacoeconomic evaluation,the economical efficiency of the 3 PPIs in preventing SU in the patients with CSCI from high to low order was pantoprazole,omeprazole and lansoprazole. Conclusion: Pantoprazole,omeprazole and lansoprazole all show good effectiveness and safety in the prevention of SU,while pantoprazole is more economical than the others,and clinicians may choose drugs according to patient's conditions.
引文
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7 Farmer J,Vaccaro A,Albert TJ,et al.Neurologic deterioration after cervical spinal cord injury[J].Clinical Spine Surgery,1998,11(3):192-196
8张媛.时间护理对消化道出血患者止血的效果及健康知识的影响[J].实用临床医药杂志,2017,21(2):40-43
9王磊,赵培西,朱彦荣,等.奥美拉唑、埃索美拉唑与泮托拉唑治疗上消化道出血的成本-效果分析[J].中国医院用药评价与分析,2010,10(1):42-44
10贾宝辉,李建国,杜朝晖,等.国产泮托拉唑钠与进口奥美拉唑钠预防ICU应激性溃疡的疗效对比及成本-效果分析[J].中国药房,2005,16(7):515-517
11潘虹.泮托拉唑与兰索拉唑治疗幽门螺旋杆菌感染活动性溃疡成本-效果对比分析[J].临床合理用药,2017,10(4A):18-19
2林金峰,聂时南.应激性溃疡预防性治疗的研究进展[J].中国急救医学,2014,34(5):468-472
3阚利胜,贾连顺.颈脊髓损伤早期救治研究进展[J].中国矫形外科杂志,2013,21(4):363-367
4贾连顺.颈脊髓损伤死亡因素及其早期救治与康复研究进展[J].中国矫形外科杂志,2012,20(22):2017-2018
5湖南省临床用药质控中心.湖南省质子泵抑制剂的临床应用指导原则(试行)[J].中南药学,2016,14(7):673-683
6田伟,徐联政.奥美拉唑与兰索拉唑预防危重病并发应激性溃疡的疗效及成本-效果分析[J].中国医院用药评价与分析,2014,16(6):506-507
7 Farmer J,Vaccaro A,Albert TJ,et al.Neurologic deterioration after cervical spinal cord injury[J].Clinical Spine Surgery,1998,11(3):192-196
8张媛.时间护理对消化道出血患者止血的效果及健康知识的影响[J].实用临床医药杂志,2017,21(2):40-43
9王磊,赵培西,朱彦荣,等.奥美拉唑、埃索美拉唑与泮托拉唑治疗上消化道出血的成本-效果分析[J].中国医院用药评价与分析,2010,10(1):42-44
10贾宝辉,李建国,杜朝晖,等.国产泮托拉唑钠与进口奥美拉唑钠预防ICU应激性溃疡的疗效对比及成本-效果分析[J].中国药房,2005,16(7):515-517
11潘虹.泮托拉唑与兰索拉唑治疗幽门螺旋杆菌感染活动性溃疡成本-效果对比分析[J].临床合理用药,2017,10(4A):18-19