2种铁剂治疗妊娠期合并缺铁性贫血的成本-效果分析
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摘要
目的:评估多糖铁复合胶囊和右旋糖酐铁口服溶液治疗妊娠期合并缺铁性贫血的成本-效果。方法:将明确诊断的62例妊娠期合并缺铁性贫血门诊患者按照随机分配的方法分为试验组和对照组,每组各31例。试验组患者给予多糖铁复合胶囊(150 mg,po,qd),对照组患者给予右旋糖酐铁口服溶液(10 mL,po,bid),2组患者均治疗4周。观察2组临床症状改变,治疗前后检验学指标变化,治疗过程中发生的不良反应以及2组成本-效果分析。结果:临床疗效:试验组患者的总有效率为87.10%,对照组为70.97%,组间比较无统计学意义(P>0.05);检验学指标:2组治疗后患者的血红蛋白(hemoglobin,HB)、红细胞计数(red blood cell,RBC)、红细胞比容(hematocrit,HCT),血清铁蛋白(serum ferritin,SF)均大于治疗前,具有统计学意义(P<0.05),治疗后2组间血清铁蛋白差异有统计学意义(P<0.05);2组患者无严重不良反应,不良反应发生率相似,组间比较无统计学意义(P>0.05)。试验组和对照组的总成本分别为282.97、492.16元,成本-效果比分别为3.25、6.93,增量成本-效果比为12.97;敏感度分析结果与成本效果分析结果一致。结论:多糖铁复合物胶囊和右旋糖酐铁口服溶液均能够不同程度的改善妊娠期缺铁性贫血患者的临床症状与恢复检验学指标,多糖铁复合胶囊改善效果更优,更具经济性。
OBJECTIVE To evaluate the cost-effectiveness analysis of Polysaccharide iron complex capsules and Iron dextran oral solution in the treatment of iron deficiency anemia in pregnancy. METHODS A total of 62 pregnant women with iron deficiency anemia were randomly divided into test group and control group, with 31 cases in each group. Patients in test group were given Polysaccharide iron complex capsules((150 mg, po, qd), and the patients in the control group were given Iron Dextran Oral Solution(10 mL, po, bid). Both groups were treated for 4 weeks. Change of clinical symptoms, changes of laboratory indicators before and after treatment, adverse reactions which occurred during treatment were observed and cost-effectiveness analysis of the two groups was performed. RESULTS The total effective rate of test group was 87.10% and control group was 70.97%, with no statistical significance between the two groups(P>0.05).After treatment,the levels of HB、RBC、HCT and SF were higher than those before treatment(P<0.05),and there was statistical significance in SF between the two groups after treatment(P<0.05).There were no obvious adverse reactions, and the incidence of adverse reaction was similar(P>0.05). Total cost of test group and control group was 282.97 and 492.16 yuan respectively, and cost-effective ratio was 3.25 and 6.93 respectively. The incremental cost-effectiveness ratio was 12.97. The sensitivity analysis results were consistent with the cost-effective analysis results. CONCLUSION Polysaccharide iron complex capsules and Iron dextran oral solution can improve the clinical symptoms and inspection index of patients with iron deficiency anemia during pregnancy. The polysaccharide iron composite capsules show better improvement effect and be more cost-effective.
OBJECTIVE To evaluate the cost-effectiveness analysis of Polysaccharide iron complex capsules and Iron dextran oral solution in the treatment of iron deficiency anemia in pregnancy. METHODS A total of 62 pregnant women with iron deficiency anemia were randomly divided into test group and control group, with 31 cases in each group. Patients in test group were given Polysaccharide iron complex capsules((150 mg, po, qd), and the patients in the control group were given Iron Dextran Oral Solution(10 mL, po, bid). Both groups were treated for 4 weeks. Change of clinical symptoms, changes of laboratory indicators before and after treatment, adverse reactions which occurred during treatment were observed and cost-effectiveness analysis of the two groups was performed. RESULTS The total effective rate of test group was 87.10% and control group was 70.97%, with no statistical significance between the two groups(P>0.05).After treatment,the levels of HB、RBC、HCT and SF were higher than those before treatment(P<0.05),and there was statistical significance in SF between the two groups after treatment(P<0.05).There were no obvious adverse reactions, and the incidence of adverse reaction was similar(P>0.05). Total cost of test group and control group was 282.97 and 492.16 yuan respectively, and cost-effective ratio was 3.25 and 6.93 respectively. The incremental cost-effectiveness ratio was 12.97. The sensitivity analysis results were consistent with the cost-effective analysis results. CONCLUSION Polysaccharide iron complex capsules and Iron dextran oral solution can improve the clinical symptoms and inspection index of patients with iron deficiency anemia during pregnancy. The polysaccharide iron composite capsules show better improvement effect and be more cost-effective.
引文
[1] WHO.Global Nutrition Monitoring Framework:operational guidance for tracking progress in meeting targets for2025[EB/OL].[2018-01].http://www.who.int/nutrition/publications/operational-guidance-GNMF-indicators/zh/.
[2] Chinese Society of Perinatal Medicine.Guidelines for the diagnosis and treatment of iron deficiency and iron deficiency anemia during pregnancy[J].Chin J Perinat Med(中华围产医学杂志),2014,17(7):451-454.
[3] Jwa SC,Fujiwara T,Yamanob Y,et al.Changes in maternal hemoglobin during pregnancy and birth outcomes[J].BMC Pregnancy Childbirth,2015,15(80):1-10.
[4] Kozuki N,Lee AC,Katz J.Moderate to severe,but not mild,maternal anemia is associated with increased risk of small-for-gestational-age outcomes[J].J Nutr,2012,142(2):358-362.
[5] Su CH,HeYT,Chen DJ,et al.Clinical observation of the pregnant women with iron deficient anemiatreated by polyferosecapsules[J].J Trop Med(热带医学杂志),2012,12(2):205-207.
[6] Zhao ZY.Comparative analysis of the efficacy of different doses of iron dextran dispersible tablets in the treatment of iron deficiency anemia in pregnancy[J].World Latest Med Inf(世界世界最新医学信息文摘),2016,16(33):105-106.
[7] Xie X,Gou WL.Obstetrics and Gynecology(妇产科学)[M].Beijing,People’s Medical Publishing House,2014:93-94.
[8] Yu CZ,Zhao XL,Kang Y.High-risk factors of anemia during pregnancy and the effect on pregnancy outcomes[J].Maternal Child Health Care China(中国妇幼保健),2017,32(23):5827-5830.
[9] Pavord S,Myers B,Robinson S,et al.UK guidelines on the management of iron deficiency in pregnancy[J].Br J Haematol,2012,156(5):588-600.
[10] International Nutritional Anemia Consultative Group.Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia[EB/OL].[2010-01].http://guide.medlive.cn/guideline/5065
[11] Avni T,Bieber A,Grossman A,et al.The safety of intravenous iron preparations:systematic review and meta-analysis[J].Mayo Clin Proc,2015,90(1):12-23.
[12] Dong YR,Chen GT.Research progress of polysaccharide-iron compound[J].J Food Safety Quality(食品安全质量检测学报),2015,6(8):2890-2895.
[13] Skikne BS,Punnonen K,Caldron PH,et al.Improved differential diagnosis of anemia of chronic disease and iron deficiency anemia:aprospective multicenter evaluation of soluble transferrin receptor and the sTfR/log ferritin index[J].Am J Hematol,2011,86(1):923-927.
[2] Chinese Society of Perinatal Medicine.Guidelines for the diagnosis and treatment of iron deficiency and iron deficiency anemia during pregnancy[J].Chin J Perinat Med(中华围产医学杂志),2014,17(7):451-454.
[3] Jwa SC,Fujiwara T,Yamanob Y,et al.Changes in maternal hemoglobin during pregnancy and birth outcomes[J].BMC Pregnancy Childbirth,2015,15(80):1-10.
[4] Kozuki N,Lee AC,Katz J.Moderate to severe,but not mild,maternal anemia is associated with increased risk of small-for-gestational-age outcomes[J].J Nutr,2012,142(2):358-362.
[5] Su CH,HeYT,Chen DJ,et al.Clinical observation of the pregnant women with iron deficient anemiatreated by polyferosecapsules[J].J Trop Med(热带医学杂志),2012,12(2):205-207.
[6] Zhao ZY.Comparative analysis of the efficacy of different doses of iron dextran dispersible tablets in the treatment of iron deficiency anemia in pregnancy[J].World Latest Med Inf(世界世界最新医学信息文摘),2016,16(33):105-106.
[7] Xie X,Gou WL.Obstetrics and Gynecology(妇产科学)[M].Beijing,People’s Medical Publishing House,2014:93-94.
[8] Yu CZ,Zhao XL,Kang Y.High-risk factors of anemia during pregnancy and the effect on pregnancy outcomes[J].Maternal Child Health Care China(中国妇幼保健),2017,32(23):5827-5830.
[9] Pavord S,Myers B,Robinson S,et al.UK guidelines on the management of iron deficiency in pregnancy[J].Br J Haematol,2012,156(5):588-600.
[10] International Nutritional Anemia Consultative Group.Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia[EB/OL].[2010-01].http://guide.medlive.cn/guideline/5065
[11] Avni T,Bieber A,Grossman A,et al.The safety of intravenous iron preparations:systematic review and meta-analysis[J].Mayo Clin Proc,2015,90(1):12-23.
[12] Dong YR,Chen GT.Research progress of polysaccharide-iron compound[J].J Food Safety Quality(食品安全质量检测学报),2015,6(8):2890-2895.
[13] Skikne BS,Punnonen K,Caldron PH,et al.Improved differential diagnosis of anemia of chronic disease and iron deficiency anemia:aprospective multicenter evaluation of soluble transferrin receptor and the sTfR/log ferritin index[J].Am J Hematol,2011,86(1):923-927.
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