Cost-effect analysis of surgical and medical treatment for patients of secondary hyperparathybridism
10.3760/cma.j.cn113855-20220630-00425
- VernacularTitle:继发性甲状旁腺功能亢进患者药物和手术治疗的疗效及经济效果的比较
- Author:
Wenjie ZHANG
1
;
Hailiang REN
;
Jian WU
Author Information
1. 四川省成都市第三人民医院普外科乳腺甲状腺疾病中心 西南交通大学附属医院，成都 610031
- Keywords:
Hyperparathyroidism ,secondary;
Parathyroidectomy;
Treatment outcome
- From:
Chinese Journal of General Surgery
2023;38(2):109-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the cost-effectiveness of alfacalcidol and cinacalcet for the treatment of secondary hyperparathyroidism in dialysis patients compared with parathyroidectomy.Methods:A total of 60 patients with secondary hyperparathyroidism treated at the Third People's Hospital of Chengdu from 2011 to 2020 were studied, patients were randomly divided into three groups: cinacalcet group, alfacalcidol group and parathyroidectomy group, with 20 cases in each group.Result:The improvement rate of bone pain and skin pruritis in parathyroidectomy group were higher than that in cinacalcet group and alfacalcidol group ( χ2=16.282, P<0.001; χ2=12.823, P=0.002). After 12 months of treatment, iPTH in the parathyroidectomy group and the cinacalcet group was significantly lower than that in the alfacalcidol group ( HR=1.36, 95% CI: 1.00-1.72, P<0.001; HR=1.27, 95% CI: 0.91-1.63, P<0.001); Serum calcium in the parathyroidectomy group was significantly lower than that of the other two groups ( HR=0.18, 95% CI: 0.12-0.24, P<0.001; HR=0.14, 95% CI: 0.08-0.20, P<0.001). The cost of complications management in the parathyroidectomy group was the lowest ( H=40.534, P<0.001), with bone pain being the most cost concern ( H=38.494, P<0.001). Patients with iPTH>2 800 pg/ml had the highest costs than with 800~1 800/ml and 1 800~2 800/ml ( H=43.798, 37.260, P<0.001). Conclusion:Surgical treatment should be the first choice for patients with secondary hyperparathyroidism, especially for patients with iPTH>2 800 pg/ml and bone pain.
