Crit Care:辛伐他汀治疗ARDS具有较好的成本效益

2017-05-30 MedSci MedSci原创

研究已表明辛伐他汀治疗急性呼吸窘迫综合征(ARDS)是安全的,且副作用极小,但辛伐他汀治疗并不能改善患者的临床结果。本研究旨在评估ARDS患者接受辛伐他汀治疗12个月时的死亡率和成本效益。 采用多中心、双盲、随机对照试验设计,在是在英国和爱尔兰进行,纳入了540名接受气管插管和机械通气的ARDS患者,随机(1:1)分为辛伐他汀每日一次(剂量为80 mg)和安慰剂片治疗组,时间为28天。

研究已表明辛伐他汀治疗急性呼吸窘迫综合征(ARDS)是安全的,且副作用极小,但辛伐他汀治疗并不能改善患者的临床结果。本研究旨在评估ARDS患者接受辛伐他汀治疗12个月时的死亡率和成本效益。

采用多中心、双盲、随机对照试验设计,在是在英国和爱尔兰进行,纳入了540名接受气管插管和机械通气的ARDS患者,随机(1:1)分为辛伐他汀每日一次(剂量为80 mg)和安慰剂片治疗组,时间为28天。

结果发现,治疗后12个月时,与安慰剂组(37.3%,95% CI:31.6 - 43)相比,辛伐他汀组(31.8%,95% CI:26.1 - 37.5)的死亡率较低,但是差异并不显著。与安慰剂相比,辛伐他汀治疗的质量调整生命年(QALY)相关的增益(增量QALY:0.064,95% CI:0.002–0.127)具有统计学差异。Simvastatin花费也并不高(增量总成本–£3601,95% CI:8061–859)。在阈值是每QALY患者愿意支付20000£,辛伐他汀的成本效益概率为99%。敏感性分析表明,在方法学假设的变化中结果是稳定的,成本效益的概率从未低于90%。

总而言之,该研究表明,对于ARDS的治疗Simvastatin符合成本效益,与QALY增益和节约医疗成本具有显著的关联。在治疗后12个月患者的死亡率方面并没有显著差异。

原始出处:

A. Agus, C. Hulme, et al., Simvastatin for patients with acute respiratory distress syndrome: long-term outcomes and cost-effectiveness from a randomised controlled trial. Crit Care. 2017; 21: 108. Published online 2017 May 17. doi:  10.1186/s13054-017-1695-0.

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    2017-11-20 drwjr
  2. [GetPortalCommentsPageByObjectIdResponse(id=2040228, encodeId=23a12040228f8, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, createdName=drwjr, createdTime=Mon Nov 20 18:27:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206047, encodeId=694e20604e6c, content=好,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJqJxClEOceer0BnBaUxWib52VF2vIwT2wFiaROx4c1gicknGWebibC11icTjVHbA1FOpLNOcnIR54hpTg/0, createdBy=fcd81995753, createdName=杏林狐, createdTime=Sat Jun 03 16:21:04 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206045, encodeId=942c206045a0, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJqJxClEOceer0BnBaUxWib52VF2vIwT2wFiaROx4c1gicknGWebibC11icTjVHbA1FOpLNOcnIR54hpTg/0, createdBy=fcd81995753, createdName=杏林狐, createdTime=Sat Jun 03 16:20:35 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359846, encodeId=7a44135984638, content=<a href='/topic/show?id=8efa5402320' target=_blank style='color:#2F92EE;'>#成本效益#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54023, encryptionId=8efa5402320, topicName=成本效益)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 01 06:27:00 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368090, encodeId=b939136809024, content=<a href='/topic/show?id=f2fd938442c' target=_blank style='color:#2F92EE;'>#辛伐他汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93844, encryptionId=f2fd938442c, topicName=辛伐他汀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6fc262, createdName=zhangmingxiang, createdTime=Thu Jun 01 06:27:00 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204635, encodeId=7ce4204635ff, content=学习了。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed May 31 06:17:12 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204472, encodeId=82742044e2c5, content=研究的基础点在哪里, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue May 30 20:01:57 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204442, encodeId=844820444292, content=学习了,很好,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Tue May 30 16:24:48 CST 2017, time=2017-05-30, status=1, ipAttribution=)]
    2017-06-03 杏林狐

    好,学习了

    0

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    2017-06-03 杏林狐

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=2040228, encodeId=23a12040228f8, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, createdName=drwjr, createdTime=Mon Nov 20 18:27:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206047, encodeId=694e20604e6c, content=好,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJqJxClEOceer0BnBaUxWib52VF2vIwT2wFiaROx4c1gicknGWebibC11icTjVHbA1FOpLNOcnIR54hpTg/0, createdBy=fcd81995753, createdName=杏林狐, createdTime=Sat Jun 03 16:21:04 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206045, encodeId=942c206045a0, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJqJxClEOceer0BnBaUxWib52VF2vIwT2wFiaROx4c1gicknGWebibC11icTjVHbA1FOpLNOcnIR54hpTg/0, createdBy=fcd81995753, createdName=杏林狐, createdTime=Sat Jun 03 16:20:35 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359846, encodeId=7a44135984638, content=<a href='/topic/show?id=8efa5402320' target=_blank style='color:#2F92EE;'>#成本效益#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54023, encryptionId=8efa5402320, topicName=成本效益)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 01 06:27:00 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368090, encodeId=b939136809024, content=<a href='/topic/show?id=f2fd938442c' target=_blank style='color:#2F92EE;'>#辛伐他汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93844, encryptionId=f2fd938442c, topicName=辛伐他汀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6fc262, createdName=zhangmingxiang, createdTime=Thu Jun 01 06:27:00 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204635, encodeId=7ce4204635ff, content=学习了。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed May 31 06:17:12 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204472, encodeId=82742044e2c5, content=研究的基础点在哪里, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue May 30 20:01:57 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204442, encodeId=844820444292, content=学习了,很好,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Tue May 30 16:24:48 CST 2017, time=2017-05-30, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2040228, encodeId=23a12040228f8, content=<a href='/topic/show?id=cb0b1520365' target=_blank style='color:#2F92EE;'>#RDS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15203, encryptionId=cb0b1520365, topicName=RDS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e964, createdName=drwjr, createdTime=Mon Nov 20 18:27:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206047, encodeId=694e20604e6c, content=好,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJqJxClEOceer0BnBaUxWib52VF2vIwT2wFiaROx4c1gicknGWebibC11icTjVHbA1FOpLNOcnIR54hpTg/0, createdBy=fcd81995753, createdName=杏林狐, createdTime=Sat Jun 03 16:21:04 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206045, encodeId=942c206045a0, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJqJxClEOceer0BnBaUxWib52VF2vIwT2wFiaROx4c1gicknGWebibC11icTjVHbA1FOpLNOcnIR54hpTg/0, createdBy=fcd81995753, createdName=杏林狐, createdTime=Sat Jun 03 16:20:35 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1359846, encodeId=7a44135984638, content=<a href='/topic/show?id=8efa5402320' target=_blank style='color:#2F92EE;'>#成本效益#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54023, encryptionId=8efa5402320, topicName=成本效益)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Jun 01 06:27:00 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368090, encodeId=b939136809024, content=<a href='/topic/show?id=f2fd938442c' target=_blank style='color:#2F92EE;'>#辛伐他汀#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93844, encryptionId=f2fd938442c, topicName=辛伐他汀)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c6fc262, createdName=zhangmingxiang, createdTime=Thu Jun 01 06:27:00 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204635, encodeId=7ce4204635ff, content=学习了。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed May 31 06:17:12 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204472, encodeId=82742044e2c5, content=研究的基础点在哪里, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdicLmdJEK9VoiaDianY6fzHNN9iaGv80m39pMHU3eSnNN0kn1o0rdQ7Bz2f03Qibcf1ia7rKvxIt4UVlErF2d4gCmDC5/0, createdBy=98e31740255, createdName=cqykthl, createdTime=Tue May 30 20:01:57 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204442, encodeId=844820444292, content=学习了,很好,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Tue May 30 16:24:48 CST 2017, time=2017-05-30, status=1, ipAttribution=)]
    2017-05-31 135****7952平儿

    学习了。。。。。。。。。

    0

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    2017-05-30 cqykthl

    研究的基础点在哪里

    0

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    2017-05-30 王秀

    学习了,很好,涨知识了!

    0

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