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目的:应用动态血压监测(ABPM)评价2种规格的复方依那普利片治疗高血压的疗效、谷/峰比值,并与依那普利单药比较,探讨中国人应用依那普利/氢氯噻嗪复方制剂的合适剂量组合。方法:经2周洗脱期,平均坐位舒张压(SeDBP)为95～114 mmHg,且ABPM检查平均舒张压≥82 mmHg的高血压患者,随机分为A,B,C三组,分别口服复方依那普利(E)10mg/氢氯噻嗪(HCTZ)12．5mg或E10mg/HCTZ 6．25mg或E10mg,qd。治疗4周末,诊室SeDBP≥90 mmHg者剂量加倍,SeDBP＜90 mmHg者按原剂量治疗,继续治疗4周。于洗脱期末及治疗8周末各行ABPM和实验室检查1次。结果:治疗8周末,三组24h,日间、夜间平均血压均较给药前明显下降,A组(n=24)降压幅度优于C组(n=23)(P＜0．05),略高于B组(n=26)(P＞0．05)。B组降压幅度高于C组,但无显著差异。A,B,C组的DBP谷峰比值分别为78．88%,70．23%和45．75%。结论:复方依那普利片每日一次口服可24 h平稳降压,且E 10 mg与HCTZ 6．25 mg剂量组合为佳。
Objective: To evaluate the curative effect and the valley / peak ratio of two kinds of compound enalapril tablets for hypertension by ambulatory blood pressure monitoring (ABPM) and compare with enalapril monotherapy to explore the effect of enalapril / Hydrochlorothiazide combination preparation of the appropriate dose combination. Methods: After two weeks of elution, mean sedentary diastolic blood pressure (SeDBP) was 95-114 mmHg, and ABPM was used to detect hypertension patients with mean diastolic blood pressure ≥ 82 mmHg. Patients were randomly divided into three groups: A, B and C, Enalapril (E) 10 mg / hydrochlorothiazide (HCTZ) 12.5 mg or E10 mg / HCTZ 6.25 mg or E10 mg, qd. 4 weeks after treatment, the clinic double the dose of SeDBP≥90 mmHg, SeDBP <90 mmHg were treated according to the original dose, and the treatment was continued for 4 weeks. ABPM and laboratory tests were performed at the end of elution and at the end of 8 weeks of treatment. Results: At the end of the 8th week of treatment, the average blood pressure of 24h, daytime and nighttime in the three groups decreased significantly compared with before treatment, and the amplitude of decrease in group A (n = 24) was better than that in group C (n = 23) (P <0.05) , Slightly higher than that in group B (n = 26) (P> 0.05). Blood pressure in group B was higher than that in group C, but there was no significant difference. The DBP trough ratios of A, B and C groups were 78.88%, 70.23% and 45.75% respectively. CONCLUSION: Compound enalapril tablet can be taken orally once a day for 24 h, and the combination of E 10 mg and HCTZ 6.25 mg is better.