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目的对乙肝肝硬化失代偿期治疗方案的成本效果进行探讨与分析。方法抽取我院于2010年4月～2013年4月诊治的88例乙肝肝硬化失代偿期患者,依照随机抽签的方式将患者分成甲、乙、丙、丁四组,每组22例,利用拉米夫定治疗甲组,利用阿德福韦酯治疗乙组,利用拉米夫定+阿德福韦酯联合治疗丙组,利用恩替卡韦治疗丁组,对各组的治疗成本效果进行观察和分析。结果在ALT复常率上,甲、乙、丙、丁四组分别为50.0%、45.5%、72.7%和63.6%;在HBV-DNA转阴率上,甲、乙、丙、丁四组分别为45.5%、40.9%、77.3%和72.7%;在ALT复常率成本效果上,甲组为34463、乙组为41028、丙组为44972、丁组为42020;在HBV-DNA转阴率成本效果上,甲组为36667、乙组为43854、丙组为37540、丁组为38988。结论在治疗乙肝肝硬化失代偿期中,拉米夫定+阿德福韦酯联合治疗方案可作为首选方案。
Objective To investigate the cost effect of decompensated hepatitis B cirrhosis treatment. Methods Eighty-eight patients with decompensated hepatitis B cirrhosis who were diagnosed and treated in our hospital from April 2010 to April 2013 were randomly divided into four groups (A, B, C and D): 22 cases in each group, Group A was treated with lamivudine, group B was treated with adefovir dipivoxil, group C was treated with lamivudine plus adefovir dipivoxil, group D was treated with entecavir, and the effect of treatment cost was observed in each group And analysis. Results In ALT normalization rate, the four groups were 50.0%, 45.5%, 72.7% and 63.6% respectively; 45.5%, 40.9%, 77.3% and 72.7%, respectively. The cost-effectiveness of ALT normalization rate was 34463 in group A, 41028 in group B, 44972 in group B and 42020 in group D, In effect, 36,667 in Group A, 43,854 in Group B, 375,40 in Group C and 38,988 in Group D. Conclusion In the treatment of decompensated hepatitis B cirrhosis, lamivudine + adefovir dipivoxil combination regimen as the preferred option.