联用尼群地平治疗高血压合并胰岛素抵抗患者的疗效及费用-效果分析  

Effects of combinations of nitredipine on blood pressure and metabolic control in hypertensive patients with insulin resistance and the cost-effectiveness analysis

作　　者：李华[1] 龚艳春[1] 杜俭[1] 王德治[1] 张建良[2] 秦永文[2] 郭冀珍[1] 

机构地区：[1]上海第二医科大学附属瑞金医院高血压科,上海200025 [2]上海第二军医大学附属长海医院心内科,上海200433

出　　处：《中国新药杂志》2002年第8期641-644,共4页Chinese Journal of New Drugs

基　　金：上海市医学发展基金重点研究课题 (2 0 0 0Ⅰ -ZD0 0 1)

摘　　要：目的 :观察尼群地平与阿替洛尔联合用药 ,以及在此基础上加用二甲双胍对高血压合并胰岛素抵抗患者的血压及代谢的影响 ,并对费效比进行分析。方法 :伴胰岛素抵抗的轻、中度高血压患者 5 0例 ,随机分为 2组 ,一组给予尼群地平 10～ 2 0mg ,tid ,阿替洛尔 12 .5～ 5 0mg ,qd ,另一组在这 2种药物的基础上加用二甲双胍2 5 0mg ,tid ,2组疗程均为 6个月。结果 :2组均可有效降压 ,降压疗效无显著差异 ;2组的费效比均较低 ,加用二甲双胍虽然会使费效比略有增加 ,但对胰岛素敏感性的影响更有益。结论 :尼群地平、阿替洛尔、二甲双胍三药联合 ,不仅降压疗效确切 ,而且可有效改善糖代谢 ,价格合理。Objective:To study the efficacy of two different combinations of nitredipine (nitredipine/atenolol and nitredipine/atenolol/metformin) on blood pressure(BP) and metabolic control in hypertensive patients with insulin resistance and analyze the cost effectiveness.Methods:After a 2 week single blind placebo period,50 mild to moderate hypertensive patients with insulin resistance were randomly divided into two groups:23 cases received nitredipine 10～20mg,tid, po and atenolol 12.5～50mg,qd, po ,27 cases were given metformin 250mg,tid, po besides nitredipine and atenolol.The treatment duration was 6 months.The main outcome measures were changed in BMI, waist circumference, BP,lipid profiles,blood glucose and Cederholm insulin sensitivity index(ISI),cost effectiveness ratio were calculated.Results:In each group, a significant BP reduction can be achieved with few side effects and low cost effectiveness ratio. Application of metformin made cost effectiveness ratio a little increased,but waist circumference significantly decreased and ISI significantly improved.Conclusion:The combination nitredipine/atenolol/metformin has dual beneficial effects on BP and glucose metablism,moreover,it seems to be an economical therapeutic regimen for hypertensive patients with insulin resistance.

关 键 词：联合用药 尼群地平 二甲双胍 阿替洛尔 高血压 费用-效果分析 治疗 

分 类 号：R544.105[医药卫生—心血管疾病] R972.4[医药卫生—内科学]