目的 分析比较持续皮下胰岛素输注(CSII)与胰岛素多次皮下注射治疗2型糖尿病(T2DM)的成本效果.方法 选取2016年1月—2017年1月天津市第三中心医院内分泌科收治的T2DM患者271例为研究对象,根据治疗方法,将患者分为A组(128例)、B组(143例).A组采用胰岛素泵泵入门冬胰岛素治疗1周,后继续给予胰岛素皮下注射和/或口服降糖药物治疗;B组给予每日多次胰岛素皮下注射或联合口服降糖药物治疗.记录患者住院期间血糖达标天数、胰岛素用量,以及使用降糖药物所产生的成本.结果 两组血糖达标天数、成本、总有效率比较,差异无统计学意义(P>0.05);A组胰岛素用量高于B组,成本效果比低于B组(P<0.05).与A组比较,B组增量成本效果比为2.38.结论 依据药物经济学基本原理,采用CSII治疗T2DM患者效价比更优,具有较好的增量成本效果比.%Objective To compare the cost-effectiveness of continuous subcutaneous insulin infusion(CSII) versus multiple daily insulin injections(MDII) for the treatment of patients with type 2 diabetes mellitus(T2DM).Methods A total of 271 T2DM patients admitted to the Department of Endocrinology, Tianjin Third Central Hospital from January 2016 to January 2017 were enrolled and assigned to Groups A(n=128) or B(n=143) according to different treatment. Patients in Group A received insulin via an insulin pump for 1 week, followed by subcutaneous insulin injections and/or oral antidiabetic therapy; subjects in Group B were given MDII or combination with oral antidiabetic therapy. The persistence of normal blood glucose levels after treatment, use of insulin and the cost of antidiabetics were recorded during the hospital stay.Results There were no significant differences in the persistence of normal blood glucose, the cost of antidiabetics or the total effective rate between Groups A and B(P>0.05). The use of insulin were significantly higher in Group A than in Group B, while cost-effectiveness was significantly lower in Group A than in Group B(P<0.05). In addition, the incremental cost-effectiveness ratio was 2.38 in Group B relative to Group A.Conclusion Based on our pharmacoeconomic analysis, CSII is superior to MDII in terms of its cost-effectiveness ratio and has a higher incremental cost-effectiveness ratio for the treatment of T2DM patients.
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