Garrido Antonio, Iborra María Isabel, Saperas Esteban, de Sousa Mónica
Servicio de Aparato Digestivo, Hospital Virgen del Rocío, Sevilla, España.
Med Clin (Barc). 2010 May 8;134(13):577-82. doi: 10.1016/j.medcli.2009.11.038. Epub 2010 Feb 26.
The aim of this study is to assess the prevalence of peptic ulcer rebleeding by comparing patients who received omeprazole versus pantoprazole i.v. as well as to study the costs of each treatment.
Retrospective and observational study. Information was gathered on sex and age of the patients, the diagnosis of upper gastrointestinal bleeding (UGB) according to the classification of Forrest, the type of proton pump inhibitor (PPI) i.v. used and the treatment regimen, presence or absence of rebleeding, mortality and data on health costs through a pharmacoeconomic cost-effectiveness analysis.
We included 807 patients, 490 of whom (60.7%) received pantoprazole and 317 (39.3%) omeprazole. There was no difference between the average age of both groups, 61.2 years vs 62.3, p=0.544; sex, 71% men vs 68.6%, P=.78; the percentage of patients within Forrest I was 35.1% vs 42%, P=.05, in grade II was 50.2% vs 40.4%, P=.006 and in grade III was 14.7% vs 17.7%, P=.259. The number of vials per day of treatment was significantly lower in the pantoprazole group from the third to fifth day, with no differences in the first two days and the sixth. There was rebleeding in 8.2% of patients treated with pantoprazole and 11.7% with omeprazole, P=.098. 2.2% of patients treated with pantoprazole died vs 2.6% treated with omeprazole, P=.086. The expected cost of a patient treated with pantoprazole was 2188.25 euro vs 3279.02 euro with omeprazole, P<.001.
While the results of the administration of omeprazole vs pantoprazole i.v. in patients with UGB are similar, the latter turns out to have a better cost-effectiveness profile.
本研究旨在通过比较接受静脉注射奥美拉唑与泮托拉唑的患者来评估消化性溃疡再出血的发生率，并研究每种治疗方法的成本。
回顾性观察研究。收集患者的性别和年龄、根据福里斯特分类法诊断的上消化道出血（UGB）、静脉使用的质子泵抑制剂（PPI）类型和治疗方案、是否存在再出血、死亡率以及通过药物经济学成本效益分析得出的健康成本数据。
我们纳入了807例患者，其中490例（60.7%）接受泮托拉唑治疗，317例（39.3%）接受奥美拉唑治疗。两组患者的平均年龄无差异，分别为61.2岁和62.3岁，p = 0.544；性别方面，男性比例分别为71%和68.6%，P = 0.78；福里斯特I级患者的比例分别为35.1%和42%，P = 0.05，II级分别为50.2%和40.4%，P = 0.006，III级分别为14.7%和17.7%，P = 0.259。从第三天到第五天，泮托拉唑组每天的用药瓶数显著低于奥美拉唑组，前两天和第六天无差异。接受泮托拉唑治疗的患者中有8.2%发生再出血，接受奥美拉唑治疗的患者中有11.7%发生再出血，P = 0.098。接受泮托拉唑治疗的患者死亡率为2.2%，接受奥美拉唑治疗的患者死亡率为2.6%，P = 0.086。接受泮托拉唑治疗的患者预期成本为2188.25欧元，接受奥美拉唑治疗的患者为3279.02欧元，P < 0.001。
虽然在UGB患者中静脉注射奥美拉唑与泮托拉唑的治疗结果相似，但后者的成本效益更高。
