赖诺普利治疗原发性高血压的临床疗效观察  

CLINICAL EFFECT OF LISINOPRIL IN PATIENTS WITH ESSENTIAL HYPERTENSION

作　　者：孙兴昌 陶萍 冯建章[2] 张朝阳 楚建民 冯秀华[2] 陈富荣[2] 

机构地区：[1]中国医学科学院阜外医院临床药理研究室,北京100037 [2]广东心血管病研究所

出　　处：《中国临床药理学杂志》1994年第3期136-142,共7页The Chinese Journal of Clinical Pharmacology

摘　　要：在北京、广州的两家医院用赖诺普利(lisinopril,Zestril,捷赐瑞)和依那普利(enalapril)治疗轻、中度原发性高血压,对其疗效进行了临床研究.120例轻、中度原发性高血压患者进入随机双盲对照试验,试验药赖诺普利与对照药依那普利各60例.赖诺普利组每次服10～40mg,每日1次,8wk后平均坐位血压由治疗前20.83/13.76kPa(156.2/103.2 mmHg)降至17.65/11.59 kPa(132.4/86.9mmHg),每日10～20mg,显效率为63.1%,降压作用持续20～24h,依那普利组每次10～40mg,每日1次,8wk后平均坐位血压由治疗前的20.71/13.65kPa(155.3/102.4mmHg)降至18.0/11.77kPa(135.0/88.3mmHg).每日10～20mg,显效率为52.2%,降压作用持续12～14h.研究结果表明两组间临床疗效有显著性差异,有效率分别为95%与85.1%.两组中常见的不良反应为头疼、头晕及咳嗽,在继续用药后逐渐消失.无因不良反应而退出试验者.两组实验室检查未见异常.根据以上研究结果,我们认为赖诺普利的临床疗效优于依那普利,是较好的抗高血压药物之一.Lisinopril, a long - acting angiotensin converting enzyme inhibitor, is effective inthe treatment of essential hypertension. The antihypertensive effects and safety profiles of lisinopril (10 -40 mg) and enalapril (10-40 mg) once daily were compared in a randomized, double-blind parallel group trial in 107 patients with mild - to - moderate essential hypertension. After 8 weeks of therapy, lisinopril reduced mean sitting systolic blood pressure (SBP) from 156.2 mmHg at baseline to 132.4 mmHg. Sitting diastolic blood pressure (DBP) was reduced from 103. 2 mmHg at baseline to 86.9 mmHg. Enalapril reduced mean SBP from 155. 3 to 135. 0 mmHg and mean DBF from 102. 4 to 88. 3 mmHg. Comparison of the two groups revealed significant difference in effect (P<0. 05) . There was also significant difference in the percentage of responders between lisinopril and enalapril group (95% vs 85.1%) . There was 63.1% responders to the dosed 10 -20 mg once daily in lisinopril group, and 52. 2% in enalapril group. The antihypertensive effect of lisinopril could persist for 20 to 24 hours while that of enalapril for only 12 to 14 hours.The commonest adverse effects in the two groups were headache, dizziness, asthenia and cough. No patient withdrew from the treatment because of adverse reactions. No abnormal laboratory results were recorded in either group.In conclusion the clinical effect was significantly better in the lisinopril group compared with that of the enalapril group in controlling essential hypertension. Compared with the placebo group lisinopril once daily could satisfatorily reduce ambulatory blood pressure for 20 to 24 hours.Lisinopril was well tolerated by Chinese patients with mild - to - moderate hypertension as shown in this study.

关 键 词：原发性 高血压 赖诺普利 依那普利 疗效 

分 类 号：R544.105[医药卫生—心血管疾病]