三种序贯用药方案根除幽门螺杆菌的成本-效果分析

目的：比较3种10d序贯用药方案根除幽门螺杆菌（Hp）感染的成本-效果。方法：快速尿素酶试验和14 C尿素呼气试验发现Hp阳性病人156例,随机分成3组：前5d,3组病人均给予奥美拉唑20mg＋阿莫西林1.0g,bid。后5d,A组（n=54）给予奥美拉唑20mg＋左氧氟沙星200mg＋呋喃唑酮200mg,bid;B组（n=50）给予奥美拉唑20mg＋加替沙星200mg＋克拉霉素500mg,bid;C组（n=52）给予奥美拉唑20mg＋替硝唑1.0g,bid以及莫西沙星400mg,qd。疗程结束4周后,行14 C尿素呼气试验,阴性者为根除。比较3组病人Hp根除率、不良反应上报率,并进行成本-效果分析。结果：A、B、C组病人的Hp根除率分别为90.7%、92.0%和92.3%,差异无统计学意义（P〉0.05）;总成本分别为102.02、132.72和149.62元,成本-效果比分别为1.12、1.44和1.62,差异有统计学意义（P〈0.01）。结论：3种治疗方案中,A方案为根除Hp感染的较优方案。

Cost-effectiveness analysis of three sequential regimens for the eradication of Helicobacter pylori

Objective： To assess cost-effectiveness analysis of 3 sequential regimens for the eradication of Helicobacter py- lori （Hp）. Methods： Rapid urease test and 14 （;-urea breath test were used for the diagnosis of Hp infection. One hundred and fif- ty-six patients with Hp infection （detected by positive rapid urease test and 14 C-urea breath test） were randomly divided into 3 groups： groups A,B and C. For the first 5 days of therapy,the patients in the 3 groups were all given 20 mg omeprazole＋l. 0 g amoxicillin,twice a day. During following 5 days of therapy, the patients in group A （n= 54） were administered 20 mg ome- prazole＋200 mg gatifloxacin＋200 mg furazolidone,also twice a day. The patients in group B （n=50） were given 20 mg ome- prazole＋200 mg gatifloxacin＋500 mg clarithromycin,all twice daily. The patients in group C （n=52） were given 20 mg ome- prazole＋ 1.0 g tinidazole （both twice a day）＋400 mg moxifloxacin （once a day）. Four weeks after termination of the treatment course,14 C-urea breath test was performed,with negative detection as a sign to prove that Hp hid been eradicated. Hp eradica- tion rate,incidence of adverse drug reactions （ADRs） and cost-effectiveness were compared between the 3 groups. Results： Hp eradication rates of groups A,B and C were 90.7% ,92.0% and 92.3% ,respectively. There were no significant differences be- tween them （P〈0.05）. Total costs for the treatment of groups A,B and C were 102.02,132.72 and 149.62 Yuan,respective- ly. And the cost-effectiveness ratios of the 3 groups were 1.12,1.44 and 1.62, respectively. Significant differences could be not- ed,when comparisons were made between them （P〈0.01）. Conclusion： Of the 3 regimens, regimen A was more superior for the eradication of Hp.