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| 小儿肺炎支原体感染后气道高反应临床诊治的成本-效果分析 |
| 唱浩1*,李小英1,茅宝山1,余玛珍1,徐通2,刘双安1,单海燕1,沈为群1,孙丽萍1,皇甫蔓晟1,颜芬1 |
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| (1.第二军医大学长征医院闸北分院儿科,上海 200070;2.第二军医大学长征医院儿科,上海 200003) |
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| 摘要: |
| 目的探讨孟鲁司特钠和硫酸沙丁胺醇缓释胶囊治疗小儿肺炎支原体肺炎(mycoplasma pneumoniae,MPP)气道高反应的成本及效果。方法以2007年10月至2008年10月374例支气管肺炎患儿为观察对象,确诊为肺炎支原体感染185例(抗体滴度≥1160或双份血清试验4倍以上升高),将其中合并气道高反应的118例患儿纳入本研究,并分为常规治疗(A组)、常规治疗+硫酸沙丁胺醇缓释胶囊(B组)及常规治疗+孟鲁司特钠(C组),统计各组患儿刺激性咳嗽的发生率、治疗后刺激性咳嗽持续时间、缓解时间及住院天数,测定呼吸峰流速值；以上海市二级甲等医院的收费标准进行成本-效果分析。结果肺炎支原体肺炎患儿气道高反应的发生率为63.8%；与常规治疗组相比,应用硫酸沙丁胺醇缓释胶囊与孟鲁司特钠均可缩短患儿刺激性咳嗽的病程；成本-效果分析提示硫酸沙丁胺醇缓释胶囊组的成本效果优于孟鲁司特钠组,成本-效果比为0.86(P<0.05)。结论考虑临床疗效和医疗费用,硫酸沙丁胺醇缓释胶囊治疗无其他合并症的MPP患儿较孟鲁司特钠有更好的成本-效果,值得临床借鉴。 |
| 关键词: 支原体肺炎 气道高反应 成本-效果分析 |
| DOI：10.3724/SP.J.1008.2010.0297 |
| 投稿时间：2009-02-18修订日期：2009-10-09 |
| 基金项目: |
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| Cost-effectiveness analysis of diagnosis and treatment of airway hyperresponsiveness in children after mycoplasma pneumonia |
| CHANG Hao1*, LI Xiao-ying1, MAO Bao-shan1, YU Ma-zhen1, XU Tong2, LIU Shuang-an1, SHAN Hai-yan1, SHEN Wei-qun1, SUN Li-ping1, HUANGFU Man-sheng1, YAN Fen1 |
| (1. Department of Pediatrics, Zhabei Branch of Changzheng Hospital, Second Military Medical University, Shanghai 200070, China; 2. Department of Pediatrics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China) |
| Abstract: |
| ObjectiveTo compare the cost-effectiveness of montelukast and salbutamal for the treatment of children with airway hyperresponsiveness (AHR) after mycoplasma pneumoniae(MPP).Methods A total of 374 children with pneumonia during Oct.2007 to Oct.2008 were observed,and 185 of them had mycoplasma infection (four-fold or greater rise by paired serum sample or higher than 1160 by a single serum sample).Of the 185 patients 118 complicated with AHR were included for cost-effectiveness analysis.They were divided into three groups,namely,routine treatment (group A),routine treatment plus salbutamal (group B),routine treatment plus montelukast (group C).The incidence,duration and alleviating time of stimulating cough and hospital stay were observed in the three groups.The peak expiratory flow (PEF) was also determined.Cost-effectiveness analysis was performed using the costs of the first class second level hospital in Shanghai.ResultsThe incidence of AHR was 63.8% in children with mycoplasma infection pneumonia in our group.Montelukast and salbutamal shortened the course of stimulating cough compared with group A.Cost-effectiveness analysis revealed that the cost of salbutamal was less than that of montelukast,with the cost-effectiveness ratio being 0.86(P<0.05).ConclusionSalbutamal is more cost-effective than montelukast for MPP children without other complications,which is a valuable information for clinicians. |
| Key words: mycoplasma pneumonia airway hyperresponsiveness cost-effectiveness analysis |
