福辛普利及依那普利治疗轻中度高血压病疗效比较.docVIP

福辛普利及依那普利治疗轻中度高血压病疗效比较 福辛普利和依那普利治疗轻中度高血压病的疗效比较 2010-08-02 诸骏仁　王宪衍　徐伟　杨蕊敏　金翠燕　钱珠 　　【摘要】　目的　比较福辛普利和依那普利治疗轻中度高血压病的疗效和安全性。方法　随机开放对照试验，经2周安慰剂导入期，139例轻中度高血压患者进入8周治疗期，每日1次服用福辛普利10 mg(74例)或依那普利5 mg(65例)，2周后如舒张压≥90 mmHg则剂量加倍，4周后如仍无效则每日加服双氢克尿噻25 mg。结果　两组药物均能明显降低血压(P0.001)；福辛普利有效率90.1%，依那普利有效率88.9%(P0.05)。福辛普利和依那普利组分别有38%和51%患者加用利尿剂(P0.05)。福辛普利降压谷峰值比率59.9%，依那普利为47.1%。最常见不良反应是咳嗽，两组各4例。结论　对轻中度高血压病福辛普利是一种有效、安全且易耐受的降压药，每日1次能维持24小时降压效应。 　　【关键词】　高血压　　血管紧张素转换酶抑制剂 Comparison of fosinopril and enalapril in the treatment of mild to moderate essential hypertension　Zhu Junren, Wang Xianyan, Xu Wei, et al. Zhong Shan Hospital, Shanghai Medical University, Shanghai 200032 　　【Abstract 】　Objective　To compare the efficacy and safety of fosinopril and enalapril in the treatment of mild to moderate hypertension. Methods　Following a 2-week placebo period, 139 patients entered an 8-week randomized, parallel study with either 10 mg fosinopril (n=74) or 5 mg enalapril (n=65) once daily. Dose doubling and the addition of dihydrochlorothiazide 25 mg once daily were required if diastolic blood pressure ≥90 mmHg at week 2 and week 4 respectively. Results　Blood pressure were significantly reduced in both groups (P0.001). There was no significant difference in responder rates between fosinopril treated patients (90.1%) and patients taking enalapril (88.9%). The addition of diuretic was required in 38% of patients on fosinopril and 51% of patients on enalapril. The trough to peak ratios were calculated as 59.9% for fosinopril and 47.1% for enalapril. Cough was the most common side effect, observed in 4 patients in each group. Conclusion　Fosinopril once daily is effective, safe and well tolerated in mild to moderate hypertensive patients. 　　【Key words 】　hypertension　　ACE inhibitor 　　福辛普利属新的含次磷酸基团的血管紧张素转换酶(ACE)抑制剂［1］，1991年起先后在欧美上市，这是1994年进入我国后进行的第一次临床试验，旨在比较福辛普利和依那普利治疗轻中度高血压的疗效和安全性。 对象和方法 　　一、病例选择 　　1.入选标准：年龄20～70岁，坐位舒张压95～110 mmHg(1 mmHg=0.133 kPa)，收缩压≤200 mgHg。 　　2.排除标准：继发性高血压；3个月内曾患急性心肌梗塞；充血性心力