动态血压监测多方法同时比较评价依那普利降压疗效

目的 用动态血压评价依那普利降压疗效并进行总体疗效判断和4种判效方法学比较。方法 对58例严格选择的轻－中度高血压病人用依那普利单盲法治疗前后比较动态血压和偶测血压结果，并进行A、B、C、D4种方法比较。结果 A法降压总有效率89．6％，B法79．3％、C法72．5％、D法67．2％；判断一致性（K值）在A与B、C、D之间分别为0．11、0．04、0．18（P值均＞0．05），B与C或D之间分别为0．44（P＜0．05）、0．33（P＞0．05）、C与D间为0．68（P＜0．01）；平均特异性和敏感性分别为A法16．4％和92．5％、B法41．1％和87．5％、C法56．7％和84．2％、D法73．6％和77．3％。结论 依那普利中小剂量晨起一次性给药4周后能平稳降低全天血压，但有效率判断方法中不同方法有不同效果，推荐以D法为佳。

Evaluation of Antihypertensive Effects by Enalapril with Multi-Method of ABPM

Objective To observe the antihypertension effect with enalapril and compare the results with different evaluation methods(A,B,C,D) Methods ABPM were performed before and after treatment with enalapril (10 to 15 mg per day) by single blind study in 58 mild moderate hypertensions for 4 w According three kind of ABPM judgement and CBP ordinary method(A) to analyse the efficacy of enalapril. Results The total response rate(%) of antihypertensive therapy judged by method A?B?C?D were 89 6%?79 3% ?72 5% ?67 2% respectively; The kappa values in comparing A to B,C or D were 0 11,0 04,0 18, respectively and all were no statistic difference( P >0 05), B to C or D were 0 44 ( P <0 05),0 33 ( P >0 05), C to D was 0 68 ( P <0 01). Specificity and sensitivity of method A were 16 4% and 92 5%,B 41 1% and 87 5%, C 56 7% and 84 2%, D 73 6% and 77 3%,respectively Conclusions Enalapril adiministrated once daily at morning could reduce BP smoothly throughout 24 hours, but different effect rate depends upon the relevant judge method , we believe D method be the best