两种联合用药方法治疗轻、中度原发性高血压的疗效比较  

Comparison of two combination regimens in the treatment of mild to moderate essential hypertension

作　　者：陶波[1] 郭冀珍[1] 陈绍行[1] 吴顺娣[1] 陆旭辉[1] 林伯贤[1] 

机构地区：[1]上海交通大学附属瑞金医院高血压科,上海200025

出　　处：《中国新药杂志》2006年第7期550-553,共4页Chinese Journal of New Drugs

摘　　要：目的:比较国产厄贝沙坦与非洛地平或雷米普利合用对轻、中度原发性高血压的降压疗效。方法:60例轻、中度高血压患者随机分两组,经2周安慰剂导入期后,治疗期共8周,其中前4周为单药期,单服厄贝沙坦150 mg, qd;4周后试验组(n=27)联合服用非洛地平5 mg,qd,对照组(n=33)联合服用雷米普利5 mg,qd,均为4周。观察治疗前及治疗后4周和8周24 h动态血压监测,并测治疗前后坐位血压。结果:试验组与对照组治疗4周后坐位血压总有效率分别从48．1％和33．3％增加到88．9％和69．7％;试验组单用4周后无效病例14例,合用非洛地平4周后,显效10例(71．4％),有效2例(14．3％),无效2例(14．3％);对照组无效病例22例合用雷米普利4周后,显效11例(50．0％),有效2例(9．1％),无效9例(40．9％),经Ridit分析,两组降压疗效无显著差异(P>0．05)。动态血压单用4周无效病例,继续合用非洛地平或雷米普利4周后,试验组有效8例(66．7％),无效4例(33．3％);对照组有效4例(36．4％),无效7例(63．6％),经X2检验,2组疗效有显著差异(P<0．05)。试验组平滑指数SBP为(0．68±0．70), DBP为(0．56±0．78);对照组平滑指数SBP为(0．64±0．72),DBP为(0．70±0．69),两组比较无显著差异(P> 0．05)。结论:厄贝沙坦与非洛地平或雷米普利联合用药均有叠加降压作用,当单用厄贝沙坦无效时,前者组合比后者疗效更优,用动态血压的方法分析更加敏感。Objective：To compare antihypertensive effects of two combination regimens in the treatment of mild to moderate essential hypertension. Methods：60 patients with mild and moderate hypertension were randomly assigned to one of two treatment groups. All patients orally received irbesartan 150 mg daily for 4 weeks immediately after a 2-week wash-out period, and subsequently administered either the combination of irbesartan 150 mg with felodipine 5 mg （n = 27 ） or with ramipril 5 mg （n = 33 ） daily for additional 4 weeks. The sitting blood pressure and the 24-hour ambulatory BP monitoring （ABPM） were monitored at 0, 4 and 8 weeks of the therapy. Results： In the secondary 4-week course of therapy, the total response rates of the sitting BP for felodipine- and ramipril-treated patients were increased by 88.9% and 69.7% from 48. 1% and 33.3% ; Of 14 patients who were not responding to irbesartan in the first 4-week course of therapy and were then randomized to the combination of irbesartan and felodipine, 10 patients （71.4%） experienced dominant effects, 2 （14.3%） had effects and 2 （ 14.3% ） showed no effects in the improvement of sitting BP in the secondary 4-week course of therapy. Of 22 patients who were not responding to irbesartan in the first 4-week course of therapy and were then randomized to the combination of irbesartan and ramipril, 11 patients （50.0%） had dominant effects, 2 （9. 1% ） showed effects and 9 （40.9%） gave no effects in the sitting BP in the secondary 4-week course of therapy; the P values in both treatment groups showed no significant difference by Ridit analysis （P 〉 0. 05 ）. Patients who had no respondance to the ABPM in the first 4-week of therapy showed effect rate of 66. 7% vs. 36.4% and no effect rate of 33.3% vs. 63.6% in the felodipine and ramipril groups in the secondary 4-week course of therapy; the P values of both combination regimens showed a statistical difference by the χ^2 test （P 〈 0. 05）. The smoothness index of SBP and DBP

关 键 词：厄贝沙坦 非洛地平 雷米普利 原发性高血压 动态血压监测 平滑指数 随机对照试验 

分 类 号：R969.4[医药卫生—药理学] R972.4[医药卫生—药学]