硝苯地平及氨氯地平和美托洛尔治疗老年原发性高血压的成本－效果分析

Cost-effect analysis of nifedipine, amlodipine and metoprolol in the treatment of essential hypertension

目的分析硝苯地平、苯磺酸氨氯地平和美托洛尔3种不同药物治疗老年原发性高血压的成本一效果。方法将180例老年原发性高血压患者完全随机分为硝苯地平组、苯磺酸氨氯地平组及美托洛尔组，每组60例。硝苯地平组予以硝苯地平治疗，1次／d，30mg／次；苯磺酸氨氯地平组予以氨氯地平治疗，5mg／次，1次／d；美托洛尔组予以美托洛尔治疗，50mg／次，2次／d。治疗8周后，比较3组患者临床疗效，计算成本并进行成本一效果分析。结果苯磺酸氨氯地平组有效率明显高于硝苯地平组、美托洛尔组[95．0％（57／60）比85．0％（51／60）、78．3％（47／60）]，差异有统计意义（P〈0．05）。硝苯地平组、苯磺酸氨氯地平组及美托洛尔组成本一效果比分别为3．57、2．32、1．54，增量成本．效果比硝苯地平组、苯磺酸氨氯地平组分别为18．22、5．94。结论3种药物中，氨氯地平是治疗老年原发性高血压经济有效的最佳选择。

Objective To study the cost-effect of nifedipine, amlodipine and metoprolol in the treatment of essential hypertension. Methods All 180 patients with essential hypertension were randomly divided into nifedipine group, amlodipine group and metoprolo] group; each group had 60 cases. Nifedipine group was treated with nifedip- ine（30 mg per time, 1 time per clay）, amlodipine group was treated with amlodipine （5 mg per time and 1 time per day） and metoprolol group was given metoprolol（50 mg per time, 2 times per day）. After 8 weeks, the clinical efficacy and cost-effect were compared. Results The clinical efficacy in amlodipine group was better than that in nife- dipine group and metoprolol group [ 95.0% （ 57/60 ） vs 85.0% （ 51/60 ） ,78.3 % （ 47/60 ）, P 〈 0.05 ] ; the cost-effectiveness among nifedipine group, amlodipine group and metoprolol group were 3.57, 2.32 and 1.54. The incremental cost among nifedipine group, amlodipine group were 18.22 and 5.94. Conclusion Amlodipine has the best cost-effect in the three drugs for treatment of older essential hypertension.