原发性高血压左室肥厚两种治疗方案的疗效及最小成本分析

目的比较氨氯地平和氯沙坦治疗原发性高血压左室肥厚的临床疗效和经济学效果。方法将70例原发性高血压患者随机分为两组,治疗组（n=35例）给予氨氯地平2.5mg,对照组（n=35例）给予氯沙坦50mg,皆于早晨7时顿服,疗程均为6个月。并运用药物经济学的最小成本分析法对两种药物的经济效果进行评价。结果治疗前后两组患者24h动态血压及心脏超声监测值的变化值均有显著性差异（P〈0.01）;两组间比较,治疗后的降压效果及逆转左室肥厚的变化值无显著性差异（P〉0.05）。氨氯地平组的治疗总费用为1121.14元,氯沙坦组的治疗总费用为2108.57元,氨氯地平组每位患者可节省费用987.43元。结论两种药物治疗逆转原发性高血压左室肥厚的临床效果相似,从经济学角度来看氨氯地平更具优势。

Effects and Cost-minimization Analysis of Amlodipine and Losartan in Treatment of Left Ventricular Hypertrophy in Patients with Essential Hypertension

Objective To compare the clinical efficacy and the economic effect of amlodipine and losartan in the treatment of left ventricular hypertrophy in the patients with essential hypertension.Methods Seventy essential hypertension (EH) patients with left ventricular hypertrophy (LVH) were randomly divided into two groups.The therapeutic group (35 cases) was given amlodipine 2.5 mg and the control group (35 cases) was given losartan 50 mg,in two groups each patient took the medicine at a draught in the morning orally,the course of treatment in two groups were six months,respectively.The economic effects were evaluated by cost- minimization analysis of pharmaco- economics.Results The results of ambulatory blood pressure in 24 h and the ultrasonic monitoring values had significant difference between the two groups (P < 0.01). The value of depressurization and reversal LVH had no significant difference between the two groups (P > 0.05).The total cost of each case was 1 121.14 yuan in the therapeutic group and 2 108.57 yuan in the control group.Everyone in the therapeutic group was cut down directly by 987.43 yuan.Conclusion The clinical efficacy was similar on reversing LVH in the patients with EH in two groups.Amlodipine is superior to losartan for the treatment of left ventricular hypertrophy in the patients with essential hypertension from the viewpoint of the economics.