缬沙坦／氢氯噻嗪复方片剂与依那普利／氢氯噻嗪复方片剂治疗轻中度原发性高血压的疗效观察  

Efficacy of compound enalapril and compound valsartan in patients with mild and moderate primary hypertension

作　　者：王莉[1] 黄岩 汪芳[2] 成小如 何奇明[3] 庞会敏 边文彦 李一石 

机构地区：[1]中国医学科学院心血管病研究所中国协和医学院阜外心血管病医院临床药理中心卫生部心血管药物临床研究重点实验室,北京100037 [2]北京医院心内科,北京100730 [3]北京大学首钢医院首钢办公厅保健室,北京100041

出　　处：《中国新药杂志》2009年第3期222-224,261,共4页Chinese Journal of New Drugs

摘　　要：目的：应用动态血压监测评价复方依那普利与复方缬沙坦治疗轻中度原发性高血压的降压疗效。方法：40例平均坐位舒张压（SeDBP）为95～114mmHg，且动态血压监测检查24h平均舒张压≥82mmHg的轻中度原发性高血压患者，随机分为两组，接受复方依那普利（依那普利10mg＋氢氯噻嗪12．5mg），qd，或接受复方缬沙坦（缬沙坦80mg＋氢氯噻嗪12．5mg），qd，治疗8周。在洗脱期末及治疗8周末各行动态血压监测和实验室检查1次。实验结束3个月后原两组轻中度原发性高血压患者又经2周洗脱期后，交叉接受复方缬沙坦或复方依那普利均qd，治疗8周，在洗脱期末及治疗8周末各行ABPM和实验室检查一次。结果：动态血压监测结果显示，两组治疗后24h平均收缩压、舒张压均显著降低（P〈0．001）。复方依那普利组收缩压、舒张压降低较复方缬沙坦组略明显，但两组间比较无统计学差异；复方依那普利组收缩压、舒张压降低的谷峰比分别为60．45％和53．24％；复方缬沙坦组分别为85．22％和78．96％；两组谷峰比值均〉50％能维持24h降压。不良反应少。结论：复方依那普利与复方缬沙坦治疗原发性轻中度高血压，均能有效降低收缩压、舒张压。每日1次口服可维持24h平稳降压。Objective： To evaluate the efficacy of compound enalapril and compound valsartan in patients with mild and moderate primary hypertension by monitoring dynamic blood pressure. Methods： In an open-labeled, randomized and crossover designed trial, 40 patients with primary hypertension [ mean age 51.54 ± 8.12y, defined as mean sitting diastolic blood pressure （SeDBP） between 95 mmHg and 114 mmHg and 24 h mean DBP≥ 82 mmHg with dynamic blood pressure monitoring] were enrolled. After 2 weeks washout period, they were treated with either enalapril 10 mg/hydrochlorothiazide 12.5 mg or valsartan 80 mg/hydrochlorothiazide 12.5 mg, once-daily for 8 weeks. At the end of the washout period and the treatment period, a non-invasive 24-h dynamic BP monitoring （ABPM） was performed and laboratory examination was conducted. Results： Dynamic monitoring of blood pressure indicated a significant reduction in average 24-h systolic blood pressure （SBP） and DSP after treatment in the two groups （P 〈0.001 ）. The degree of reduction in SBP and DBP was more conspicuous in compound enalapril group than in compound valsartan group, but no statistical difference was found between the two groups. Trough/peak （T/P） SBP and T/P DBP reduced by 60.45% and 53.24% , respectively, in the compound enalapril group; and 85.22% and 78.96% , respectively, in the compound valsartan group. T/P in the two groups was more than 50% and this hypotensive effect maintained for 24 h. The adverse reactions were mild. Conclusion： Compound enalapril and compound valsartan can effectively lower DSP and SBP in patients with mild and moderate primary hypertension. Administration once daily can maintain 24-h steady reduction in BP.

关 键 词：缬沙坦 依那普利 氢氯噻嗪 动态血压 高血压 

分 类 号：R972.4[医药卫生—药品]