Page 85 - 202001

·药物经济学·

帕拉米韦对比奥司他韦治疗流行性感冒合并热性惊厥患儿的药

物经济学评价 Δ

2
1
1
1＊
1
陈圣洁 ，徐梅先 ，李成玲 ，东 蕾 ，安志华（1.河北省儿童医院药学部，石家庄 050031；2.河北省儿童医院
重症医学科，石家庄 050031）
中图分类号 R956 文献标志码 A 文章编号 1001-0408（2020）01-0075-06
DOI 10.6039/j.issn.1001-0408.2020.01.13

摘 要 目的：比较帕拉米韦和奥司他韦治疗流行性感冒（简称流感）合并热性惊厥患儿的有效性和经济性。方法：采用回顾性研
究方法，收集2018年12月－2019年3月我院收治的152例流感合并热性惊厥的住院患儿，根据其用药情况分为帕拉米韦组81例，
奥司他韦组71例。比较两组患儿的发热缓解时间、用药天数、住院天数、临床效果（以抽搐、咳嗽、鼻塞、流涕、咽痛等进行判定）、
皮疹发生率和联用抗生素、中药的患儿例数。采用成本-效果分析法评价两组患儿用药方案的成本-效果比（CER）和增量成本-效
果比（ICER）。通过下调15％的药品价格重新计算CER和ICER的方法以及采用有序Logistic回归对效果和多元线性回归对总成
本进行敏感性分析。结果：两组患儿的发热缓解时间、用药天数、住院天数、皮疹发生率和联用抗生素患儿占比差异均无统计学意
义（P＞0.05），但联用中药患儿占比和临床效果差异有统计学意义，帕拉米韦组联用中药患儿占比显著低于奥司他韦组（P＜
0.001），临床效果显著优于奥司他韦组（P＝0.021）。帕拉米韦组和奥司他韦组的总成本分别为 5 442.84 元/人和 5 571.71 元/人
（P＝0.795）、CER分别为54.47和56.51，帕拉米韦组的ICER为－89.38。敏感性分析结果与基础分析结果一致。结论：与奥司他韦
相比，帕拉米韦治疗流感合并热性惊厥患儿的效果更好，成本更低。
关键词 流感；热性惊厥；儿童；奥司他韦；帕拉米韦；成本-效果分析

Pharmacoeconomic Evaluation of Peramivir versus Oseltamivir in the Treatment of Influenza Complicated
with Febrile Seizures for Children
CHEN Shengjie ，XU Meixian ，LI Chengling ，DONG Lei ，AN Zhihua （1.Dept. of Pharmacy，Children’s
1
1
2
1
1
Hospital of Hebei Province，Shijiazhuang 050031，China；2.ICU，Children’s Hospital of Hebei Province，
Shijiazhuang 050031，China）
ABSTRACT OBJECTIVE：To compare the effectiveness and economics of peramivir and oseltamivir in the treatment of
influenza complicated with febrile seizures in children. METHODS：In retrospective study，152 children with influenza complicated
with febrile seizures were collected from our hospital during Dec. 2018 to Mar. 2019.They were divided into peramivir group（81
cases） and oseltamivir group （71 cases）. Fever remission time， medication duration， hospital duration， clinical efficacy
（determined by convulsion，cough，nasal obstruction，runny nose，sore throat，etc.），the incidence of rash，the number of
children with combined antibiotic and TCM were compared between 2 groups. Cost-effectiveness analysis was used to evaluate
cost-effectiveness ratio（CER）and incremental cost-effectiveness ratio（ICER）of medication regimen in 2 groups. The sensitivity
analysis of the effect and total cost were carried out with Logistic regression and multiple linear regression respectively through
CER and ICER calculated by reducing 15％ drug price. RESULTS：There was no statistical significance in fever remission time，
medication duration，hospitalization duration，the incidence of rash and proportion of children with combined antibiotics between 2
groups （P＞0.05）. There was statistical significance in proportion of children with combined TCM and clinical effect，and the
proportion of children with combined TCM in peramivir group was significantly lower than oseltamivir group（P＜0.001）. Clinical
effect of peramivir group was significantly better than that of oseltamivir group（P＝0.021）. Total cost of peramivir group and
oseltamivir group were 5 442.84 yuan/person and 5 571.71 yuan/person（P＝0.795）；CER of them were 54.47 and 56.51；ICER of
peramivir group was － 89.38. The results of sensitivity analysis were consistent with those of basic analysis.CONCLUSIONS：
Compared with oseltamivir，peramivir is more effective and less costly for children with influenza and febrile seizures.
KEYWORDS Influenza；Febrile seizures；Children；Oseltamivir；Peramivir；Cost-effectiveness analysis

热性惊厥（Febrile seizures，FS）为儿童时期发热所
Δ 基金项目：河北省省级科技计划项目（No.182777133）；河北省
医学科学研究重点课题计划（No.20170391） 诱发的惊厥，多见于 6 个月～5 岁患儿，患病率为 3％～
[1]
＊副主任药师。研究方向：医院药学。电话：0311-85911027。 5％ 。如果FS引起的抽搐时间较长或者多次发生抽搐，
E-mail：csj1971@163.com 则可对患儿的大脑及发育造成不可逆的损伤，甚至会诱

中国药房 2020年第31卷第1期 China Pharmacy 2020 Vol. 31 No. 1 ·75 ·