多中心评价银杏内酯注射液治疗重症缺血性脑卒中药物经济学

目的 研究多中心银杏内酯注射液治疗重症缺血性脑卒中的临床疗效、经济性、安全性，评价药物经济价值。方法 采用前瞻性队列研究方法，纳入了2013年8月-2013年12月各中心重症缺血性脑卒中患者共119例，以银杏内酯注射液加常规治疗的患者为治疗组，共78例；对照组41例，患者在常规治疗基础上可使用其他活血化瘀类药物。在出院后3、6、12个月对两组患者进行电话随访，获取药效指标：日常生活活动能力评价（ADL）评分、生活自理患者比例、痊愈率、复发率、全因死亡率；经济学指标：成本效果比（CER）；以及不良事件发生情况，评估患者采用不同治疗方案的远期获益差异。结果 出院后3、6、12个月，治疗组ADL评分、痊愈率和自理率均优于对照组，且差异显著（P<0.05）；出院后6个月，治疗组复发率优于对照组，且差异显著（P<0.05）；出院后12个月，治疗组复发率和死亡率优于对照组，且差异显著（P<0.05）；出院后3、6、12个月，治疗组的CER均明显小于对照组；两组不良反应发生率均较低。结论 远期评估发现，经银杏内酯注射液治疗患者较未接受其治疗患者临床效果更佳，CER更优，证明了银杏内酯注射液治疗重症脑卒中的有效性及经济性。

Multicenter evaluation on pharmacoeconomics of Ginkgolide Injection in treatment of severe ischemic stroke

Objective To study the clinical efficacy, economical efficiency, and security of Ginkgolide Injection in the treatment of severe ischemic stroke in multicenter, and evaluate the economic value of drugs.Methods A prospective cohort study was conducted in this study, a total of 119 patients with severe ischemic stroke were collected from August 2013 to December 2013. In the treatment group, 78 patients were treated with Ginkgolide Injection and routine treatment; In the control group, 41 patients were treated with routine treatment (other blood stasis drugs can be used). The patients were telephone followed-up visited 3, 6, and 12 months after discharge for pharmacodynamic indexes (ADL score, self-care rate, recovery rate, recurrence rate, and all-cause mortality), economic indicators (cost effectiveness ratio, CER), and adverse events, so as to assess the patients with long-term benefit differences after different treatments.Results Follow-up in 3, 6, and 12 months after discharge showed that ADL score, recovery rate and self-care rate of treatment group were better than control group, and the difference was significant (P < 0.05). In the 6 months after discharge, the recurrence rate of treatment group was superior to control group, and the difference was significant (P < 0.05). In the 12 months after discharge, the recurrence rate and death rate of the treatment group were superior to the control group, and the difference was significant (P < 0.05). In the 3, 6 and 12 months after discharge, the CER of the treatment group was less than the control group (P < 0.05). The incidence of adverse reactions was lower in both groups.Conclusions Long-term assessment found that Ginkgolide Injection had better clinical outcomes and better CER than those without it, which proved the effectiveness and economic efficacy of Ginkgolide Injection in the treatment of severe ischemic stroke.