氯沙坦与贝那普利治疗轻中度高血压的成本-效果评价

目的比较氯沙坦与贝那普利治疗轻中度高血压的疗效,以及这两种药物的经济学评价。方法采用随机双盲实验,将轻、中度高血压病患者随机的分为氯沙坦组(41例)和贝那普利组(41例),给药剂量分别是氯沙坦50mg/d和贝那普利20mg/d,疗程为8周。每两周随访一次,治疗前及治疗后2、4、6周,分别进行坐位收缩压、舒张压测量并进行疗效比较。并对两种方案进行成本-效果分析。结果 6周末,氯沙坦组有效率为82.9%,贝那普利组为80.5%,两组间无显著差异(P>0.05)。两组平均DBP和SBP均有显著下降,两组间血压降幅无显著差异(P>0.05)。氯沙坦组的成本-效果比值要高于贝那普利组。但是,干咳等副作用发生率氯沙坦组为2.4%,贝那普利组为9.8%,差异有显著性(P<0.01)。结论氯沙坦治疗轻、中度高血压安全、有效,患者依从性较好。相同单位疗效时,贝那普利组的成本较低,但不良反应的发生率较高。

Cost Effectiveness Evaluation of Losartan and Benner Pury in the Treatment of mild to Moderate Essential Hypertension

Objective To compare the curative effect of losartan and benazepril in the treatment of mild-to-moderate hypertension.To evaluate the antihypertensive efficacy and tolerability of the angiotensin II receptor antagonist losartan in patients with mild to moderate essential hyper tension.as wel as the economic evaluation of the two drugs.Methods Patient s with mild to moderate hypertension were enrol ed in this randomized,double-blind study.After 2 weeks placebo baseline phase,patient s were randomly al ocated to receive losartan 50 mg once daily（losartan group,n=41）or benazepril 10 mg once daily（benazepril group,n=41）for 8 weeks.The daily dosage was doubled in patient s whose SiDBP remained≥90 mm Hg after 4 weeks treatment.SiDBP,SiSBP,heart rate,the incidence of dry cough and clinical laboratory measurement s were assessed at the end of 2 weeks placebo phase,4 and 6 weeks active treatment. Results At the end of 6 weeks,the effective rates did not differ significantly between the losartan group and the benazepril group（82.9% vs 80.5%,P＆gt;0.05）.The mean r educt ions in SiDBP and SiSBP were significant in the two groups,and did not differ significantly between the two groups（P＆gt;0.05）.The losartan group had a significantly lower rate of dry cough than the benazepril group（2.4% vs 9.8%,P＆lt;0.01）.Conclusion Losartan is effective and wel tolerated with a very low incidence of dry cough in patient s with mild to moderate hypertension.Same units curative effect,that the cost of the captopril group is low,but high incidence of adverse reactions.