左旋氨氯地平与氨氯地平的药物经济学系统评价  

Pharmacoeconomic Evaluation of Levamlodipine and Amlodipine for Treating Hypertension:A Systematic Review

作　　者：张颖[1] 蔡旭阳 杨甜 吴斌[1] 徐珽[1] 吴逢波[1] Zhang Ying;Cai Xuyang;Yang Tian;Wu Bin;Xu Ting;Wu Fengbo(Department of Pharmacy,West China Hospital,Sichuan University,Chengdu,Sichuan,China 610041)

机构地区：[1]四川大学华西医院药剂科,四川成都610041

出　　处：《中国药业》2018年第23期40-43,共4页China Pharmaceuticals

基　　金：2018年四川省卫生和计划生育委员会科研课题(普及应用项目)[18PJ533];2017年四川省医学会高血压疾病(施慧达)专项科研课题[2017SHD005]

摘　　要：目的系统评价左旋氨氯地平和氨氯地平对高血压患者的药物经济学效益、疗效和安全性。方法计算机检索CNKI,CBM,Ovid Medline,Cochrane Library等数据库中从建库至2017年12月发表的与左旋氨氯地平和氨氯地平相关的药物经济学评价文献,并应用RevMan 5. 3软件分析。结果共纳入10篇文献,其中4篇报道左旋氨氯地平基于收缩压降低值的成本-效果比(元/mm Hg)均低于氨氯地平,8篇报道基于总有效率的成本-效果比(元/%)均低于氨氯地平。Meta分析结果显示,两种药物治疗高血压的总有效率差异无统计学意义[RR=1. 03,95%CI(0. 98,1. 09),P=0. 29],左旋氨氯地平的舒张压降低值[MD=2. 67,95%CI(1. 45,3. 89),P <0. 000 1]和安全性[RR=0. 42,95%CI(0. 25,0. 72),P=0. 002]优于氨氯地平。结论基于现有临床证据,与氨氯地平相比,左旋氨氯地平或是更经济、更安全的降血压药物。Objective To systematically evaluate the pharmacoeconomic benefit, clinical effectiveness and safety of levamlodipine and amlodipine in treating patients with hypertension. Methods The database such as CNKI, CBM, Ovid Medline, Cochrane Library were searched from inception to December 2017, with the related to the pharmacoeconomic evaluation of levamlodipine and amlodipine. RevMan 5.3 software was applied to analyze the data. Results A total of 10 RCTs were included. The cost- effectiveness ratio of levamlodipine was lower than that of amlodipine, basing on SBP reduction in 4 articles and total efficiency in 8 articles respectively. The result of Meta- analysis showed that there was no significant difference in the total effective rate of two drugs in the treatment of patients with hypertension[ RR = 1.03, 95% CI（0.98, 1.09）, P=0. 29]. While the levamlodipine was superior to amlodipine in DBP reduction values[MD=2.67, 95% CI（1.45, 3.89）, P 〈 0.000 1] and safety[RR=0.42, 95% CI（0.25, 0.72）, P=0.002] . Conclusion Based on the current clinical evidence, compared with amlodipine, levamlodipine may be a economical as well as safe anti - hypertensive drug.

关 键 词：左旋氨氯地平 氨氯地平 高血压 药物经济学 系统评价 

分 类 号：R956[医药卫生—药学] R972.4