福辛普利治疗轻、中度原发性高血压疗效和安全性的系统评价  

Efficacy and Safety of Fosinofril for Mild to Moderate Essential Hypertension:A Systematic Review

作　　者：曾晓[1,2] 刘晶[1,2] 陈进兵[1,2] 奚炜[1,2] 邢翔飞[1,2] 李娜[1,2] 刘薇芝[3] 金桂兰[1,2] 胡汉昆[3] 

机构地区：[1]三峡大学人民医院 [2]宜昌市第一人民医院药学部,湖北宜昌443000 [3]武汉大学中南医院,武汉430071

出　　处：《中国药房》2014年第36期3372-3376,共5页China Pharmacy

基　　金：国家科技支撑计划子课题(No.2013BAI06B04Y023142)

摘　　要：目的:系统评价福辛普利治疗轻、中度原发性高血压的疗效和安全性,以为临床提供循证参考。方法:计算机检索中国期刊全文数据库、万方数据库、中文科技期刊全文数据库(维普资讯)、PubMed、Cochrane Library、EMBase(Ovid)、Medline(Ovid)、Medline In-Process,收集福辛普利治疗轻、中度原发性高血压的随机对照试验(RCT),提取资料后采用Cochrane协作网专用的Rev Man 5.2统计软件进行Meta分析。结果:纳入18项RCT,合计1 511例患者。Meta分析结果表明,福辛普利可以显著降低轻、中度原发性高血压患者的收缩压(SBP)和舒张压(DBP),其降压效果与钙离子拮抗剂比较差异无统计学意义,但显著优于部分利尿药;福辛普利与氢氯噻嗪合用可显著降低患者SBP,对DBP的降低作用与其他药物比较差异无统计学意义;与中药相比,福辛普利的降压作用主要表现为降低患者SBP,对DBP的降低作用与中药比较差异无统计学意义;福辛普利治疗轻、中度原发性高血压的不良反应发生率与其他药物比较差异无统计学意义。结论:福辛普利治疗轻、中度原发性高血压的疗效与钙离子拮抗剂相当,优于其他类型的抗高血压药物,安全性亦较好。由于纳入研究数量较少、质量偏低,该结论有待高质量、大样本的RCT进一步证实。OBJECTIVE：To evaluate therapeutic efficacy and safety of fosinopril in the treatment of mild to moderate essential hypertension systematically,and to provide evidence-based reference for clinical use. METHODS：Retrieved from CNKI,Wanfang database,VIP,Pubmed,Cochrane Library,EMBase（Ovid）,Medline（Ovid）and Medline In-Process, RCT about fosinopril in the treatment of mild to moderate essential hypertension were collected,and Meta-analysis was conducted by using Rev Man 5.2statistical software provided by Cochrane collaboration net. RESULTS：A total of 18 RCTs were included,involving 1 511 patients.Meta-analysis showed that fosinopril could significantly reduce the systolic blood pressure（SBP） and diastolic blood pressure（DBP）. Antihypertensive effect of calcium antagonists and fosinopril showed no statistical significance. The antihypertensive efficacy of fosinopril was better than that of some diuretics. Fosinopril combined with hydrochlorothiazide can significantly lower SBP.There was no statistically significant difference between it and other drugs in reducing DBP. Compared with TCM,the antihypertensive efficacy of fosinopril displayed the reduction of SBP;there was no statistically significant difference in the reduction of DBP between fosinopril and TCM. There was no statistically significant difference in the incidence of ADR between fosinopril and other drugs. CONCLUSIONS：The curative effect of fosinopril is almost the same as calcium antagonists in the treatment of mild to moderate essential hypertension,but superior to other types of antihypertensive drugs and shows good safety. Due to small-scale and low-quality included studies,this conclusion needs to be further confirmed by large-scale and high-quality RCT.

关 键 词：福辛普利 原发性高血压 临床疗效 安全性 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]