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Crit Care:辛伐他汀治疗急性呼吸窘迫综合征的长期结局和成本效益如何?

2017-05-17 xing.T MedSci原创

在ARDS的治疗上辛伐他汀被认为是具有成本效益,并与显著的QALY增益和成本节省相关。12个月的死亡率没有显著减少。

辛伐他汀治疗急性呼吸窘迫综合征(ARDS)已被证明是安全的,并且具有最小的副作用,但它并不能改善临床结果。近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,研究人员旨在评估ARDS患者采用辛伐他汀治疗12个月的死亡率和成本效益。

这是一项成本效用分析,是在英国和爱尔兰进行的一项多中心、双盲、随机对照试验。540名气管插管和机械通气的ARDS患者被随机(1:1)接受每日一次的辛伐他汀治疗(剂量为80mg)或相同的安慰剂治疗,长达28天。

12个月后辛伐他汀组死亡率较低(31.8%,95%可信区间(CI)为26.1-37.5),相比于安慰剂组(37.3%,95%CI为31.6-43),虽然这并不显著。辛伐他汀与质量调整生命年(QALY)增益(增量QALY为0.064,95%CI为0.002-0.127)显著相关,相比于安慰剂。辛伐他汀也不昂贵(增量总成本为£3601,95%CI为-8061至859)。每QALY的意愿支付阈值为£20000,辛伐他汀具有成本效益的概率为99%。敏感性分析表明在方法学假设上结果对变化稳健,成本效益的概率从来没有低于90%。

在ARDS的治疗上辛伐他汀被认为是具有成本效益,并与显著的QALY增益和成本节省相关。12个月的死亡率没有显著减少。

原始出处:

A. Agus,et al. Simvastatin for patients with acute respiratory distress syndrome: long-term outcomes and cost-effectiveness from a randomised controlled trial.Critical Care.2017. https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1695-0

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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/y1ZJaAFo7AFqm7Hn2QNVTjOpBV9mRicUEjyBqRMnLADF1oQXJGeIVCpiaY1hJVMd1C40EhFCw4LL8sCKTx8Yuvsw/132, createdBy=af0b1960284, createdName=孙文杰, createdTime=Thu May 18 21:32:33 CST 2017, time=2017-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199608, encodeId=17c019960894, content=学习了,但是这个死亡率也并不显著,可以说是很接近的一个。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Thu May 18 14:17:37 CST 2017, time=2017-05-18, status=1, ipAttribution=)]
    2017-05-19 龙胆草

    学习了,谢谢分享

    0

  7. 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/y1ZJaAFo7AFqm7Hn2QNVTjOpBV9mRicUEjyBqRMnLADF1oQXJGeIVCpiaY1hJVMd1C40EhFCw4LL8sCKTx8Yuvsw/132, createdBy=af0b1960284, createdName=孙文杰, createdTime=Thu May 18 21:32:33 CST 2017, time=2017-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199608, encodeId=17c019960894, content=学习了,但是这个死亡率也并不显著,可以说是很接近的一个。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Thu May 18 14:17:37 CST 2017, time=2017-05-18, status=1, ipAttribution=)]
    2017-05-19 chunjianf

    学习了,谢谢分享

    0

  8. 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/y1ZJaAFo7AFqm7Hn2QNVTjOpBV9mRicUEjyBqRMnLADF1oQXJGeIVCpiaY1hJVMd1C40EhFCw4LL8sCKTx8Yuvsw/132, createdBy=af0b1960284, createdName=孙文杰, createdTime=Thu May 18 21:32:33 CST 2017, time=2017-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199608, encodeId=17c019960894, content=学习了,但是这个死亡率也并不显著,可以说是很接近的一个。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Thu May 18 14:17:37 CST 2017, time=2017-05-18, status=1, ipAttribution=)]
    2017-05-19 半夏微凉

    学习了谢谢分享

    0

  9. 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/y1ZJaAFo7AFqm7Hn2QNVTjOpBV9mRicUEjyBqRMnLADF1oQXJGeIVCpiaY1hJVMd1C40EhFCw4LL8sCKTx8Yuvsw/132, createdBy=af0b1960284, createdName=孙文杰, createdTime=Thu May 18 21:32:33 CST 2017, time=2017-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199608, encodeId=17c019960894, content=学习了,但是这个死亡率也并不显著,可以说是很接近的一个。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Thu May 18 14:17:37 CST 2017, time=2017-05-18, status=1, ipAttribution=)]
    2017-05-18 孙文杰

    学习了,希望下次翻译的再好一点,加油~

    0

  10. 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encodeId=87cf199894a8, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri May 19 08:21:48 CST 2017, time=2017-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199823, encodeId=59a1199823a4, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRk75KAEKrLGic0S0IvH1aNynsEFQWiaNKdtzvtwj2kafCoPg2icYVbrfBCFiaS74X1uEiaaTTY1H9Xyem/0, createdBy=cec11614828, createdName=chunjianf, createdTime=Fri May 19 06:30:04 CST 2017, time=2017-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199769, encodeId=8c23199e692e, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Fri May 19 04:45:53 CST 2017, time=2017-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199691, encodeId=ba0c19969149, content=学习了,希望下次翻译的再好一点,加油~, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/y1ZJaAFo7AFqm7Hn2QNVTjOpBV9mRicUEjyBqRMnLADF1oQXJGeIVCpiaY1hJVMd1C40EhFCw4LL8sCKTx8Yuvsw/132, createdBy=af0b1960284, createdName=孙文杰, createdTime=Thu May 18 21:32:33 CST 2017, time=2017-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=199608, encodeId=17c019960894, content=学习了,但是这个死亡率也并不显著,可以说是很接近的一个。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160911/IMG57D51CE461BD24798.jpg, createdBy=91d61672802, createdName=西风染林, createdTime=Thu May 18 14:17:37 CST 2017, time=2017-05-18, status=1, ipAttribution=)]
    2017-05-18 西风染林

    学习了,但是这个死亡率也并不显著,可以说是很接近的一个。

    0

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