缬沙坦和贝那普利治疗原发性高血压左室肥厚效果比较的系统评价  

Systematic review of the effect comparison of valsartan and benazepril on left ventricular hypertrophy in patients with essential hypertension

作　　者：李雨露[1] 李一梅[1] 谢波[1] 李琼[1] 胡乾配 江莲[1] 

机构地区：[1]重庆医科大学附属永川医院全科医学科,重庆402160

出　　处：《中国医药导报》2017年第9期136-141,共6页China Medical Herald

摘　　要：目的对缬沙坦和贝那普利治疗原发性高血压左心室肥厚效果对比进行系统评价。方法使用计算机检索Ovid、Pub Med、MEDLINE、Cochrane Library、Embase、中国生物医学文献数据库(CBM)、维普网、中国知网、万方等数据库,检索时间设置为从建库至2016年4月。根据Cochrane系统评价方法,筛选出关于缬沙坦对比贝那普利治疗原发性高血压左心室肥厚的中英文随机对照试验(RCT),对纳入的文献进行数据提取和质量评价,运用Rev Man5.2软件进行Meta分析。结果最终纳入12篇符合条件的随机对照试验。Meta分析结果显示:(1)缬沙坦与贝那普利相比,降低收缩压(MD=-0.86,95%CI=-2.83~1.10,P=0.39)和舒张压(MD=0.48,95%CI=-0.63~1.59,P=0.40)的差异无统计学意义。(2)缬沙坦逆转高血压左心室肥厚效果优于贝那普利[LVMI(MD=2.15,95%CI=0.62~3.70,P=0.006)、LVPWT(MD=0.14,95%CI=0.12~0.16,P<0.000 01)]。(3)缬沙坦不良反应发生率明显低于贝那普利(OR=0.32,95%CI=0.20~0.51,P<0.000 01)。结论与贝那普利相比,缬沙坦治疗高血压左室肥厚效果更好,不良反应更少。Objective To systematically evaluate the efficacy of valsartan and benazepril in treating left ventricular hy- pertrophy in patients with essential hypertension. Methods The databases of Ovid, PubMed, MEDLINE, Cochrane Li- brary, Embase, Chinese Biomedical Literature Database （CBM）, VIP, CNKI and Wanfang were retrieved on line from the database foundation to April 2016. According to the method of Cochrane systematic review, the Chinese and Eng- lish literatures were selected,which were randomized controlled trials（RCTs）, about valsartan and benazepril in treating essential hypertension with LVH. The data were extracted and the quality of the screened literatures were assessed. Meta analysis was conducted by RevMan5.2 software. Results A total of 12 RCTs were finally included. Meta analysis showed that ： ①here was no statistical difference in lowing systolic blood pressure（SBP） （MD=-0.86, 95%CI =-2.83 -1.10, P = 0.39）and diastolic blood pressure （DBP） （MD=0.48, 95%CI =-0.63-1.59,P=0.40） between the valsartan group and benazepril group. ②Valsartan group was better than benazepril group in reversing LVH [LVMI（MD=2.15, 95%CI = 0.62-3.70,P = 0.006）, LVPWT（MD=0.14, 95%CI =0.12-0.16,P〈0.000 01）]. ③Valsartan group had less adverse reac- tion than benazepril group （OR=0.32, 95%CI=0.20-0.51, P〈0.000 01）. Conclusion The systematic review shows that valsartan is superior to the benazepril in the treatment of essential hypertension with LVH and its adverse reaction is less than that of benazepril.

关 键 词：缬沙坦 贝那普利 原发性高血压 左室肥厚 系统评价 

分 类 号：R544.1[医药卫生—心血管疾病]