治疗原发性高血压3种药物治疗方案的成本-效果分析

目的：探讨分析3种药物治疗原发性高血压的成本-效果。方法：选择180例原发性高血压患者,随机归入3组,每组60例,分别使用富马酸比索洛尔胶囊（A组）、马来酸依那普利片（B组）、吲达帕胺片（C组）进行治疗（非降压辅助药品可以有差异）,疗程为100d。运用药物经济学成本-效果对比方法进行分析。结果：3种药物的治疗成本分别为214.2元、27元、36.5元,有效率分别为48.33%、43.33%、46.67%,成本-效果比分别为4.43、0.62、0.78。结论：B组为最佳治疗方案,C组成本-效果比与B组差别不大,可作为B组的备选方案。     

高血压病3种治疗方案的药物经济学研究

目的：探讨氯沙坦，吲达帕胺，氯沙坦和吲达帕胺联用3种治疗高血压病方案的药物经济学效果。方法：根据文献数据对61例高血压患者，随机分成3组，给与不同治疗方案（A：氯沙坦，B：吲达帕胺；C：氯沙坦与吲达帕胺联用），对这3种方案的临床治疗效果进行成本-效果分析。结果：3种方案总成本分别为955.68,749.69及975.28元；对高血压的降压效果分别为76.2%,75%和90%。结论：通过成本-效果分析。氯沙坦与吲达帕胺联用方案为治疗高血压的最佳治疗方案。     

原发性高血压采用国产降压药联合治疗方案的成本-效果分析

目的对3组国产降压药联合治疗原发性高血压进行成本-效果分析,为临床医生、药师和患者合理选择降压药物提供参考依据。方法选取门诊中度高血压患者90例,随机分为3组,每组30例,用3组不同药物联合治疗,分别为A（缬沙坦＋托拉塞米）、B（苯磺酸氨氯地平＋替米沙坦）、C（富马酸比索洛尔＋吲达帕胺）,3组均口服给药,运用药物经济学的成本-效果分析方法进行评价;结果经过4周的治疗观察,A、B、C组的总成本分别为519.156元、427.456元、441.064元,总有效率分别为93.33%、90.00%、83.33%,成本-效果比分别为5.56、4.75、5.29。结论 B组疗效确切,经济性最佳。同时说明药物经济学为临床合理选药、合理利用医疗资源、为患者提供个体化治疗方案均有重要的指导意义。     

3种降压药物治疗原发性高血压的成本-效果分析

目的探讨3种降压药物治疗原发性高血压的成本-效果比率,为临床提供较佳的治疗方案。方法2007年1月～2008年1月将90例原发性高血压患者随机分为A、B、C组,并给予不同的治疗方案,运用药物经济学成本-效果分析方法进行评价分析。结果A、B、C组比较,总有效率以及不良反应发生率差异无统计学意义（P〉0．05）;A组C／E、△C／△E为3组中最低。结论A组方案为较佳治疗方案。     

3种钙通道阻滞剂治疗高血压的药物经济学分析

目的分析3种钙通道阻滞剂治疗高血压的药物经济学效果。方法选取符合＂WHO/ISH高血压诊断标准＂的我院门诊患者173例,采用氨氯地平（A组）、非洛地平（B组）、硝苯地平控释片（C组）3种药物治疗,运用药物经济学进行成本-效果分析。结果 3种钙通道阻滞剂的总有效率分别为81.03%,76.79%,79.66%;成本-效果比（C/E）分别为0.94,0.97,0.97,相对A组而言,B、C组增长的成本-效果比（△C/△E）分别为0.41,0.58。结论 3种钙通道阻滞剂中氨氯地平为治疗高血压较为经济、有效的方案。     

社区原发性高血压3种治疗方案的成本-效果分析

目的评价3种治疗方案治疗社区原发性高血压的药物经济学效果。方法调查安徽省铜陵县钟鸣中心卫生院2006年6月至2008年5月动态管理的高血压患者中入选病例92例。采用卡托普利(A组)、硝苯地平缓释剂(B组)、硝苯地平缓释剂+卡托普利(C组)3种治疗方案,运用药物经济学成本-效果分析的方法进行评价。结果3种治疗方案临床有效率分别为73.30%、77.42%、93.55%;成本-效果比(C/E)分别为0.09、0.56、0.53,相对于A组而言,B、C增长的成本-效果比(△C/△E)分别为8.83、2.13。结论硝苯地平缓释剂+卡托普利(C组)是治疗社区原发性高血压最佳治疗方案。药物经济学为临床制定合理的治疗方案提供了客观依据。     

副伤寒甲三种治疗方案的成本-效果分析

目的：探讨不同药物治疗方案对同一疾病产生的效果。方法：运用药物经济学成本-效果分析法对3种治疗副伤寒甲方案进行回顾性分析评价。结果：注射用盐酸左氧氟沙星 注射用美洛西林钠（A组）治疗成本为2706.21元，成本-效果比为27.06；头孢噻肟钠（B组）治疗成本为1575.00元，成本-效果比为16.84％；注射用氨苄西林钠舒巴坦（C组）治疗成本为1969.68元，成本-效果比为20.26％。结论：三种治疗方案中以头孢噻肟钠组（B组）为最佳治疗方案。     

氨氯地平、依那普利及氢氯噻嗪在原发性高血压3种治疗方案的成本-效果分析

目的：探讨3种治疗原发性高血压方案的药物经济学效果。方法：将124例门诊原发性高血压患者随机分为3组,A组40例给予氨氯地平5mg,1次/d治疗,B组42例给予依那普利10mg,1次/d治疗,C组42例给予依那普利5mg联合氢氯噻嗪25mg,1次/d治疗,观察三组的治疗效果及不良反应情况,并进行成本-效果分析。结果：C组治疗的总有效率明显高于A组和B组,差异有统计学意义（P<0.05）,A、B两组间比较,差异无统计学意义（P>0.05）;C组的△C/△E为三组中最低;三组在不良反发生率间比较,差异无统计学意义（P>0.05）。结论：C组方案是治疗原发性高血压的最佳方案,药物经济学分析可为临床合理用药提供可靠依据。     

3种国产药物治疗原发性高血压病的成本-效果分析

目的 分析评价3种原发性高血压治疗方案的疗效及成本-效果比。方法 根据文献资料选择280例原发性高血压患者，分为厄贝沙坦，赖诺普利，特拉唑嗪3个治疗组运用药物经济学的成本-效果分析方法进行评价。结果 厄贝沙坦治疗方案为最佳方案。结论 通过分析。说明药物经济学在为临床合理用药方面可提供客观依据。     

3种方案治疗原发性高血压的成本-效果分析

目的评价3种不同药物治疗原发性高血压的经济效果。方法对111例轻、中度原发性高血压患者随机分组,分别用3种不同药物治疗,A组35例给予贝那普利片10m g,每日1次;B组38例厄贝沙坦胶囊150m g,每日1次;C组给予氨氯地平片5m g,每日1次,3组均为早晨口服给药,疗程为4周。运用药物经济学成本-效果分析方法比较。结果A、B、C组的有效率分别为91.4%,71.1%,87.9%。A组方案成本-效果比较低,且有效率高。结论A组方案为最佳。     

3种方案治疗老年性肺炎的成本-效果分析

目的：探讨不同药物的治疗方案对同一疾病所产生的经济效果。方法:采用回顾性研究方法，对经确诊 为老年性肺炎的住院患者115例,根据治疗方案不同分为3组,A组: 头孢呋辛+左氧氟沙星；B组: 头孢地嗪；C组:头孢派 酮舒巴坦。应用药物经济学成本-效果分析法进行比较。结果:A,B,C组成本依次为3 073.46元,4 248.96元,4 955.89元 ，有效率分别为84.6%,85.0%,86.1%，敏感性分析结果均与参数改变前的结果基本一致。结论:A组治疗方案优于B组、C 组。     

3种方案治疗老年性肺炎的成本-效果分析

目的：探讨不同药物的治疗方案对同一疾病所产生的经济效果。方法:采用回顾性研究方法，对经确诊 为老年性肺炎的住院患者115例,根据治疗方案不同分为3组,A组: 头孢呋辛+左氧氟沙星；B组: 头孢地嗪；C组:头孢派 酮舒巴坦。应用药物经济学成本-效果分析法进行比较。结果:A,B,C组成本依次为3 073.46元,4 248.96元,4 955.89元 ，有效率分别为84.6%,85.0%,86.1%，敏感性分析结果均与参数改变前的结果基本一致。结论:A组治疗方案优于B组、C 组。     

3种方案治疗老年性肺炎的成本-效果分析

目的：探讨不同药物的治疗方案对同一疾病所产生的经济效果。方法:采用回顾性研究方法，对经确诊 为老年性肺炎的住院患者115例,根据治疗方案不同分为3组,A组: 头孢呋辛+左氧氟沙星；B组: 头孢地嗪；C组:头孢派 酮舒巴坦。应用药物经济学成本-效果分析法进行比较。结果:A,B,C组成本依次为3 073.46元,4 248.96元,4 955.89元 ，有效率分别为84.6%,85.0%,86.1%，敏感性分析结果均与参数改变前的结果基本一致。结论:A组治疗方案优于B组、C 组。     

3种方案治疗老年性肺炎的成本-效果分析

目的：探讨不同药物的治疗方案对同一疾病所产生的经济效果。方法:采用回顾性研究方法，对经确诊 为老年性肺炎的住院患者115例,根据治疗方案不同分为3组,A组: 头孢呋辛+左氧氟沙星；B组: 头孢地嗪；C组:头孢派 酮舒巴坦。应用药物经济学成本-效果分析法进行比较。结果:A,B,C组成本依次为3 073.46元,4 248.96元,4 955.89元 ，有效率分别为84.6%,85.0%,86.1%，敏感性分析结果均与参数改变前的结果基本一致。结论:A组治疗方案优于B组、C 组。     

Long-term safety and tolerability of ezetimibe coadministered with simvastatin in hypercholesterolemic patients: a randomized, 12-month double-blind extension study

ABSTRACT

Objectives: To assess the long-term safety and tolerability and to further evaluate the effect of ezetimibe plus simvastatin on LDL-C, HDL-C, and triglyceride levels in subjects with primary hypercholesterolemia.

Methods: This was a 12-month, double-blind, placebo-controlled extension study that enrolled patients with primary hypercholesterolemia who had successfully completed the 12-week, double-blind, placebo-controlled trial of ezetimibe coadministered with simvastatin. The initial dose administered to patients in the extension was ezetimibe 10 mg coadministered with simvastatin 10 mg with the option to up-titrate statin dosage if LDL-C goals were not met. Safety and tolerability were assessed through clinical and laboratory adverse experiences (AEs). Changes from baseline in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels were measured.

Results: Overall, 87 patients were randomized to receive ezetimibe + simvastatin and 22 were randomized to receive simvastatin and placebo. Treatment-emergent AEs were reported for 72/87 (83%) ezetimibe + simvastatin-treated patients and for 17/22 (77%) simvastatin-treated patients. The most commonly reported AEs in the simvastatin treatment group were hypertension, gastro-esophageal reflux, and musculoskeletal pain (each reported by 3/22 [14%] patients); and in the ezetimibe + simvastatin group were upper respiratory tract infection (16/87 [18%]), arthralgia and musculoskeletal pain (both reported by 10/87 [11%] patients). Drug-related AEs were reported for 3/22 (14%) simvastatin-treated patients and 21/87 (24%) patients in the coadministration group. AEs considered serious by the investigator were reported by 2/22 (9%) patients taking simvastatin monotherapy and by 20/87 (23%) patients taking ezetimibe + simvastatin. Discontinuations due to AEs occurred in no patients taking simvastatin monotherapy and in 7/87 (8%) patients taking ezetimibe + simvastatin. Percent change ± standard deviation from baseline in LDL-C was ?29% ± 15.4 and ?44% ± 14.2 in subjects taking simvastatin monotherapy and ezetimibe + simvastatin, respectively.

Conclusions: Ezetimibe coadministered with simvastatin was generally well-tolerated and no new safety concerns were raised. Both treatments effectively maintained improvements in lipid parameters throughout the course of the studies. Interpretation of these results was limited by the small convenience sample included in the trial.     

Simvastatin and bezafibrate: Effects on serum lipoproteins and lecithin: Cholesterol acyltransferase activity in familial hypercholesterolaemia

Summary Sixteen subjects with familial hypercholesterolaemia were randomly assigned to treatment with simvastatin 20–40 mg/day (an inhibitor of 3-hydroxy-3-methylglutaryl CoA reductase) or with bezafibrate 600 mg/day (a clofibrate analogue) for 12 weeks.Both drugs produced significant reductions in serum and LDL cholesterol; mean percentage fall –30.5% and –38.1% (simvastatin) and –17.8% and –20.6% (bezafibrate), respectively. Both drugs also caused a decrease in VLDL cholesterol, while only bezafibrate decreased the serum and VLDL triglyceride levels and increased HDL cholesterol and serum apolipoprotein A-I and A-II levels. Serum apolipoprotein B fell by 33.3% (simvastatin) and 15.7% (bezafibrate). Simvastatin and bezafibrate produced significant increases in the mean fractional esterification rate of LCAT, by +124,1% and +20.6%, respectively.Thus simvastatin was clearly more effective than bezafibrate in lowering LDL by enhancing its turnover, but bezafibrate had specific effects on VLDL and HDL that might be favourable in combined treatment regimens.     

替米沙坦不同联用药方案治疗轻、中度原发性高血压的成本-效果分析

目的:评价替米沙坦不同联用药方案治疗轻、中度原发性高血压的成本-效果。方法:60例患者随机分为3组,分别给予替米沙坦+非洛地平(A组)、替米沙坦+依那普利(B组)、替米沙坦+吲达帕胺(C组)治疗8wk后进行成本-效果分析。结果:A、B、C组总有效率分别为90%、85%、95%;总成本分别为422.80、409.50、348.88元,C组与A、B组比较有显著性差异(P<0.05)。结论:C组方案治疗轻、中度原发性高血压较佳。     

Evaluation of a pharmacokinetic interaction between valsartan and simvastatin in healthy subjects

ABSTRACT

Objective: The potential for a pharmacokinetic drug interaction between valsartan, an antihypertensive drug, and simvastatin, a lipid-lowering agent, was investigated in this study. This was an open-label, multiple-dose, randomized, three-period, cross over study in 18 healthy subjects. Each subject received one 160?mg valsartan tablet or one 40?mg simvastatin tablet or co-administration of valsartan (160?mg) and simvastatin (40?mg) tablets for 7 days, with a 7?day inter-dose washout period. The steady-state pharmacokinetics of valsartan, simvastatin β?hydroxy acid (active metabolite of simvastatin) and simvastatin (pro-drug) were determined on day 7 of each dosing period.

Results: The results were interpreted based on the point estimates and the 90% confidence intervals.italic> These results indicated that the area under the curve of plasma concentration from 0 to 24 hours (AUC_(0–24)) of valsartan, simvastatin β?hydroxy acid and simvastatin was increased by 14%, 19%, and 23%, respectively, with the combination treatment. In addition, the maximum concentration (C_max) of valsartan and simvastatin β?hydroxy acid was increased by 10% and 22%, respectively, and the C_max of simvastatin was decreased by 26% with the combination treatment. All treatments were safe and well tolerated.

Conclusions: Based on the wide therapeutic dosage ranges of valsartan and simvastatin, and the highly variable pharmacokinetics of three analytes, the observed differences in the exposure and C_max of valsartan, simvastatin β?hydroxy acid and simvastatin in the combination treatment are unlikely to be of clinical relevance.     

2014年212例精神疾病合并高血压住院患者口服抗高血压药物临床应用的横断面调查

目的：了解精神疾病合并高血压患者的抗高血压药物应用情况。方法采用横断面调查方法,对广州市精神病医院2014年4月22日00：00～24：00时精神疾病合并高血压住院患者的抗高血压药物的临床应用进行调查。结果212例住院患者中,精神分裂症合并高血压患者占50%,发病率男性高于女性,50岁以上发病率较高。抗高血压药物使用频率排名前5位的依次是左氨氯地平片（23.24%）、厄贝沙坦片（14.07%）、硝苯地平控释片（12.23%）、氨氯地平片（10.70%）、美托洛尔片（10.09%）。治疗方案中,单一用药124例（58.49%）,二联用药75例（35.38%）,三联用药13例（6.13%）。结论该院抗高血压药的使用能够做到个体化用药,治疗高血压的方案基本合理。     

A novel granulation non-solvent addition method containing hydrophilic and lipophilic drugs

Atenolol and simvastatin were granulated in combination by non-solvent addition coacervation method to treat hypertension orally. Dissolution test was performed in water containing 0.5% sodium dodecyl sulfate at 37 0.05 degrees C. FTIR spectrometry, X-ray diffractometry and thermal analysis confirmed the absence of any chemical interaction between polymer and the entrapped drugs. The granules size was about 280-619 μm. Scanning electron microscopy reported irregular morphology of granules. The entrapment efficiency was approximately 90% for atenolol and 70% for simvastatin. A controlled release behavior of both drugs but a burst release phenomenon of simvastatin from the formulations were observed. In conclusion, granules loaded with a hydrophilic and a lipophilic drug were successfully prepared.