慢性阻塞性肺病患者接种23价肺炎球菌多糖疫苗的成本-效益分析

目的：了解23价肺炎球菌多糖疫苗对慢性阻塞性肺病（COPD）患者的预防保护效果及因此带来的经济效益.方法：从2007年10月以来曾在我院呼吸内科就诊,有完整病历资料的COPD患者资料库中,随机筛取240人入选为研究对象,随机分成疫苗组及对照组各120人.收集基线情况及通过对两组患者两年的急性发作情况、住院情况及治疗费用的跟踪随访,并对比分析两组数据.结果：疫苗组无论在COPD急性发作次数、发作持续天数、住院次数、平均住院天数及治疗成本上均显著低于对照组.疫苗组比对照组减少总治愈成本167385.18元,接种疫苗后效益成本比达到7.08,接种疫苗后净效益达到143742.18元.结论：23价肺炎球菌多糖疫苗能有效预防COPD的发作及肺部感染的严重程度和治愈时间,并显著降低COPD所致的治疗成本.

A cost-benefit analysis on use of 23-valent pneumococcal polysaccharide vaccine (PPV23) in patients with COPD

Objective： To investigate the protection and cost-benefit of 23-valent pneumococcal polysaccharide vaccine （PPV23） in COPD patients. Methods： Of all COPD patients registered to the respiratory medicine clinic of our hospital and with complete medical records since October 2007,240 patients were randomly selected and included in this study, randomized into a vaccination group or a control group （n = 120 each）. Data on baseline characteristics, as well as acute exacerbation of COPD, hospitalization and medical expenses during the previous 2 years were followed up and compared between the two groups. Results： The vaccination group showed significantly fewer episodes and days of acute exacerbation, less hospitalization, shorter mean length of hospital stay, and less medical cost, as compared with the control group. There was a saving of 167385.18 Yuan RMB by overall medical cost to recovery in the vaccination group compared with control group. The benefit-cost ratio was up to 7.08 ,and the net benefit up to 143742.18 Yuan after vaccination. Conclusion： The PPV23 may effectively prevent acute exacerbation of COPD, attenuate the severity of pulmonary infections and shorten the time to recovery. Moreover,the nse of PPV23 is associated with a significant reduction in COPD-related medical cost.