丁　敏　亢　锴



奥曲肽治疗肝硬化合并上消化道出血的疗效和药物经济学评价

丁敏1亢锴2

目的探索奥曲肽在治疗肝硬化合并上消化道出血的疗效及评价其药物经济学。方法将2011年11月至2015年3月在我院住院的80例肝硬化合并上消化道出血患者按随机数字表法分为观察组（n=39）和对照组（n=41）。观察组给予持续静脉泵入八肽生长抑素醋酸奥曲肽注射液25μg/h；对照组给予持续静脉泵入十四肽生长抑素250μg/h。两组患者经过治疗止血后药物逐渐减量并维持治疗72 h停药；观察比较两组患者止血时间、治疗有效率、不良反应发生情况和成本-效果比值，分析两种药物疗效并评价药物经济学。结果对于肝硬化合并上消化道出血的止血效果，观察组优于对照组，差异具有显著性（P＜0.05）；观察组与对照组在不良反应方面比较，差异没有统计学意义（P＞0.05）；观察组的成本-效果比值低于对照组，差异具有显著性（P＜0.05）。结论相比于十四肽生长抑素，奥曲肽对于肝硬化合并上消化道出血具有较好的疗效，不良反应轻微，性价比高。

肝硬化；上消化道出血；生长抑素；奥曲肽

【Abstract】Objective To investigate the efficacy and pharmacoeconom icsof octreotide in the treatment of hepatocirrhosispatientswithuppergastrointestinalbleeding.M ethods Eighty hepatocirrhosispatientswith uppergastrointestinalbleeding，from December2011 to March 2015 in ourhospital，were chosen and randomly divided into the observation group（n=39）and the controlgroup（n=41）.The observation group was treatedwith continuous intravenous pumping octreotide acetate injection 25μg/h，while the control group was treated w ith continuous intravenous pumping somatostatin 250μg/h.The tw o groupsof patientsgradually reduced the dosage andmaintained treatment for 72 hours afterhemostasis.The bleeding time，treatmenteffectiveness，adverse reactions，and the cost-effectiveness ratio of two groupswas compared.Results Theefficacy of observation group was higher than the controlgroup（P＜0.05），the adverse reactions of tw o groupshad no significantdifference（P＞0.05）.The cost-effectiveness ratio of the observation groupwassignificantly higher than the controlgroup（P＜0.05）.Conclusion Octreotide had better efficacy，lessadverse reaction，and higher performance cost ratio than somatostatin in the treatmentof hepatocirrhosis patientsw ith upper gastrointestinal bleeding.

【Key words】Hepatocirrhosis；Upper gastrointestinalbleeding；Somatostatin；Octreotide

肝硬化（hepatic cirrhosis）是一种全球性的常见病，主要是由于长期肝细胞炎症坏死，而继发肝组织弥漫性纤维化、假小叶和再生结节形成。由于发病初期没有明显症状，临床确诊常已发展到晚期［1］。主要临床表现为肝功能减退和门静脉高压。常出现胃食管静脉曲张破裂出血、继发感染、肝性脑病、肝肾综合征等严重并发症，其中最常见的为上消化道出血。……