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目的 评价在人群中筛查幽门螺杆菌感染以预防胃癌的临床和经济学效果。 方法 用Markov模型估计在10万名40岁～45岁人群中筛查幽门螺杆菌感染者并对筛查试验阳性者进行治疗的远期效果及费用,并与不进行任何干预的结果相比较,进行卫生经济学评价。对治疗感染者减少胃癌发生危险度的有效率和胃癌发病率进行敏感性分析。 结果 在有效率为50％时,每筛查10万人可减少291例胃癌的发生,增加2612个生命年。当预防胃癌的有效率从5％到100％变化时,每增加一个生命年的费用从7747元下降到2325元,在胃癌高发区筛查更经济有效。 结论 筛查幽门螺杆菌感染是一种潜在的能减少胃癌发生的有效措施。
Objectives To evaluate the clinical and economic effects of screening for Helicobacter pylori infection in a population to prevent gastric cancer. Methods The Markov model was used to estimate the long-term effects and costs of screening for H. pylori infection among 100,000 people aged 40 to 45 years old and for those who tested positive for the screening test, and compared with the results without any intervention. Health economic evaluation. The sensitivity of reducing the risk of gastric cancer and the incidence of gastric cancer in the treatment of infected persons. Results At an effective rate of 50%, 100,000 cases of screening for every 100,000 cases of gastric cancer can reduce the incidence of 2612 life years. When the effective rate of preventing gastric cancer changes from 5% to 100%, the cost of each additional life year drops from 7,747 yuan to 2,325 yuan, and it is more economical and effective to screen for high incidence of gastric cancer. Conclusion Screening for Helicobacter pylori infection is a potential effective measure to reduce the occurrence of gastric cancer.