目的:探讨坎地沙坦与依那普利联合应用对高血压合并左心室肥厚患者血压及左室重构的影响。方法:选择65例高血压合左心室肥厚患者为研究对象,随机分为2组,分别给予坎地沙坦和坎地沙坦与依那普利联合治疗,疗程共26周。采用彩色超声技术测定治疗前、后左心室肥厚的参数变化,并记录血压的变化。结果:坎地沙坦与依那普利联合应用能明显改善高血压患者左室舒张功能，逆转左室肥厚(Plt;005);坎地沙坦单用或与依那普利联合应用均能明显降低血压(Plt;005),但二者联合应用的降压效果与坎地沙坦单独应用的效果相比,差异没有显著性意义(Pgt;005)。 结论:坎地沙坦与依那普利联合应用具有较好的降压效果,并能明显阻断心室重构、改善心脏功能。
Objective To investigate the clinical effectiveness of the total Flavones of Hippophae Rhamnoides L. (TFH) and compare its cost-effectiveness ratio with enalapril in patients with essential hypertension. Methods Among 3 971 staff members in two universities, 155 eligible patients with blood pressure (BP) ≥160/100 mmHg were screened and included in this study. By using a random number table, the patients were randomized to the two groups: TFH was given to the treatment group while enalapril in the control group. At the end of the six week, BP, total cost and cost-effectiveness ratio were measured in both TFH and enalapril groups. Results After six weeks, blood pressures in the TFH and enalapril groups decreased by 12.7±11.6/8.1±5.1 mmHg and 15.2±9.7/10.1±7.3 mmHg respectively, while the improvement rates of BP were 73.24% (52/71) and 74.65% (53/71) respectively. There were no differences between TFH and enalapril groups in lowering BP amplitude and total effectiveness rate. The incidence of side effect in TFH group was 11.27% (8/71), which was significantly lower than that of enalapril 29.6% (21/71). The total cost of TFH group was 9 294.6 RMB with the cost effectiveness ratio of 732/1 147 RMB per mmHg and 179 RMB per case. In the enalapril group, the total cost added up to 13 236 RMB with cost effectiveness ratio of 870/1 310 per mmHg and 250 RMB per case. Sensitivity analysis indicated that TFH was better than enalapril with respect to clinical economic value even when enalapril price dropped to 1.8 RMB for tablet (5 mg). Conclusion Compared with enalapril, TFH is an effective and economic drug in treating patients with hypertension.
【摘要】 目的 探讨灯盏花素注射液联合血管紧张素转换酶抑制剂（ACEI）依那普利治疗糖尿病早期肾病的临床效果。 方法 2006年10月-2009年12月，将59例临床确诊2型糖尿病早期肾病的患者随机分为治疗组（n=30）与对照组（n=29）。对照组在基本治疗的基础上应用依那普利，治疗组在基本治疗的基础上联合应用依那普利和灯盏花素注射液，疗程均为3周。观察治疗前后两组患者24 h尿微量白蛋白排泄率（UAER）、全血黏度、血浆黏度、甘油三酯（TG）、尿素氮（BUN）、血肌酐（SCr）的变化。 结果 两组患者治疗前后自身对比，24 h UAER均有明显下降（Plt;0.05）；治疗组UAER下降较对照组更为明显（Plt;0.05）。 结论 ACEI联合灯盏花素，其降低24 h UAER疗效优于单纯ACEI疗效，还可有效降低全血黏度和血浆黏度，降低纤维蛋白原含量，改善患者血液流变性。【Abstract】 Objective To investigate the therapeutic effects of breviscapine combined with angiotensin converting enzyme inhibitor (enalapril) on early diabetic nephropathy. Methods A total of 59 patients with early diabetic nephropathy diagnosed between October 2006 and December 2009 were randomly divided into treatment group (n=30) and control group (n=29). The patients in treatment group were treated by breviscapine combined with enalapril, while the patients were treated with only enalapril in the control group. All of the patients were treated for three weeks. Urinaryalbuminexcretion (UAE), whole blood viscosity, plasma viscosity, triglycercide, blood urea nitrogen and serum creatinine in the two groups were detected before and after the treatment. Results After the threatment, UAE decreased in both of the two groups compared with the value before the treatment (Plt;0.05); the decrease in treatment groups was more obvious than that in the control group (Plt;0.05). Conclusion The combination of breviscapine and enalapril is effective on early diabetic nephropathy.