不同血管紧张素转换酶抑制剂治疗原发性高血压的药物经济学比较

Pharmacoeconomic comparison of different angiotensin-converting enzyme inhibitors in the treatment of essential hypertension

目的:分析5种血管紧张素转换酶抑制剂(ACEIs)治疗原发性高血压(EH)的药物经济学。方法:选择EH病人400例,分别采用国产卡托普利(A组)、合资卡托普利(开博通)(B组)、福辛普利钠(C组)、盐酸贝那普利(D组)、马来酸依那普利(E组)治疗,各80例。测定治疗前后各组收缩压(SBP)、舒张压(DBP)水平,比较5种ACEIs用于EH的治疗效果及成本。结果:治疗前,各组SBP和DBP差异均无统计学意义(P>0.05);治疗后,各组SBP、DBP均较治疗前明显降低(P<0.01),且C、D、E组均明显低于A、B组(P<0.05~P<0.01)。各组疗效差异有统计学意义(P<0.01),其中C、D、E组治疗效果均优于A、B组(P<0.05)。各组成本与效果差异均有统计学意义(P<0.01),其中B、C、D组成本、效果和C/E均高于A、E组,C、D组△C/△E均高于E组(P<0.05~P<0.01)。各组不良反应发生率差异有统计学意义(P<0.01),其中C、E组不良反应总发生率均低于A、B组(P<0.05)。结论:采用马来酸依那普利治疗EH总有效率高,安全性高,药物经济性高。

Objective:To analyze the pharmacoeconomics of five angiotensin-converting enzyme inhibitors(ACEIs)in the treatment of essential hypertension(EH).Methods:Four hundred patients with EH were treated with domestic captopril(group A),joint venture captopril(Capoten)(group B),fosinopril sodium(group C),benazepril hydrochloride(group D)and enalapril maleate(group E),respectively(80 cases in each group).The systolic blood pressur(SBP)and diastolic blood pressure(DBP)levels in five groups before and after treatment were measured,and the therapeutic effects and costs of five kinds of ACEIs for EH were compared.Results:Before treatment,the differences of the levels of SBP and DBP among five groups were not statistically significant(P>0.05).After treatment,the levels of SBP and DBP in each group were significantly lower than those before treatment(P<0.01),and which in groups C,D and E were significantly lower than those in groups A and B(P<0.05 to P<0.01).The differences of the therapeutic effects among five groups were statistically significant(P<0.01),and the therapeutic effects in C,groups D and E were better than those in groups A and B(P<0.05).The differences of the cost and effects among five groups were statistically significant(P<0.01),the cost,effects and ratio of C/E in B,groups C and A were higher than those in groups A and E,and the value of△C/△E in groups C and D were higher than that in group E(P<0.05 to P<0.01).The differences of the incidence rates of adverse reactions among five groups were statistically significant(P<0.01),and the total incidence rates of adverse reactions in groups C and E were lower than that in groups A and B(P<0.05).Conclusions:The enalapril maleate in the treatment of EH has high total efficiency,safety and drug economy.