国产肠溶阿司匹林与拜阿司匹林治疗不稳定型心绞痛的效果比较

目的探讨国产肠溶阿司匹林与拜阿司匹林治疗不稳定型心绞痛的远期疗效。方法回顾分析90例不稳定型心绞痛患者的临床资料,依照药物的不同随机将其分成A、B两组,每组45例,A组患者服用国产肠溶阿司匹林,B组患者服用拜阿司匹林,随访总结两组患者的治疗效果。结果随访发现,A组和B组患者在被迫停药、急性心肌梗死(AMI)、病死、实施冠状动脉介入治疗(PCI)和实施冠状动脉旁路移植术(CABG)发生例数比较,差异无统计学意义(P>0.05)。结论国产肠溶阿司匹林和拜阿司匹林治疗不稳定型心绞痛疗效相当,说明国产肠溶阿司匹林的治疗效果值得肯定,且服药耐受性较好。     

血栓通治疗冠心病不稳定型心绞痛疗效分析

目的探讨血栓通治疗冠心病不稳定型心绞痛的临床疗效。方法将214例不稳定型心绞痛患者分为观察组（138例）和对照组（76例）,对照组给予常规治疗,观察组在常规治疗的基础上加用血栓通注射液治疗,观察两组患者临床疗效。结果观察组临床疗效和心电图疗效总有效率为96.38%和93.48%,均明显高于对照组的78.95%和73.68%（P＜0.05）。结论血栓通注射液可提高冠心病不稳定型心绞痛的治疗疗效,值得临床推广应用。     

Differences in utility elicitation methods in cardiovascular disease: a systematic review

Aims: Utility values inform estimates of the cost-effectiveness of treatment for cardiovascular disease (CVD), but values can vary depending on the method used. The aim of this systematic literature review (SLR) was to explore how methods of elicitation impact utility values for CVD.

Materials and methods: This review identified English-language articles in Embase, MEDLINE, and the gray literature published between September 1992 and August 2015 using keywords for “utilities” and “stroke”, “heart failure”, “myocardial infarction”, or “angina”. Variability in utility values based on the method of elicitation, tariff, or type of respondent was then reported.

Results: This review screened 4,341 citations; 290 of these articles qualified for inclusion in the SLR because they reported utility values for one or more of the cardiovascular conditions of interest listed above. Of these 290, the 41 articles that provided head-to-head comparisons of utility methods for CVD were reviewed. In this sub-set, it was found that methodological differences contributed to variation in utility values. Direct methods often yielded higher scores than did indirect methods. Within direct methods, there were no clear trends in head-to-head studies (standard gamble [SG] vs time trade-off); but general population respondents often provided lower scores than did patients with the disease when evaluating the same health states with SG methods. When comparing indirect methods, the EQ-5D typically yielded higher values than the SF-6D, but also showed more sensitivity to differences in health states.

Conclusions: When selecting CVD utility values for an economic model, consideration of the utility elicitation method is important, as this review demonstrates that methodology of choice impacts utility values in CVD.     

瑞舒伐他汀联合诺新康治疗不稳定型心绞痛疗效观察

目的观察瑞舒伐他汀联合诺新康对不稳定型心绞痛强化治疗的疗效。方法 86例不稳定型心绞痛患者随机分成两组,分别给一般治疗和一般治疗加瑞舒伐他汀联合诺新康治疗,连用10-14d,观察疗效差别。结果瑞舒伐他汀联合诺新康治疗组的疗效明显优于一般治疗组。结论瑞舒伐他汀联合诺新康强化治疗可有效治疗不稳定型心绞痛。     

Economic implications of the Total Ischaemic Burden Bisoprolol Study (TIBBS) follow-up

Abstract

Data from the TIBBS follow-up and published costs were combined in an economic analysis of stable angina patients, classified into subgroups defined by number of episodes of transient ischaemia detected on 48-hour ECG (<2, 2 to 6, >6 episodes); response to therapy (100% or non-100% responders); and initial therapy received in the randomised period of TIBBS (bisoprolol or nifedipine). The mean costs per patient over 12 months were: £766, £1481, and £1914 for <2, 2 to 6, and >6 episodes respectively; £1082 and £1938 for 100% responders and non-100% responders respectively; £1372 and £2030 for patients receiving bisoprolol or nifedipine respectively. Higher frequency of ischaemic episodes on ambulant ECG predict increased costs over the following 12 months. Failure to respond to therapy for transient ischaemia may identify patients that have increased costs. Treatment of transient ischaemia with bisoprolol in stable angina patients results in reduced long-term cardiovascular events and decreased total costs in comparison to treatment with nifedipine.