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目的 本文旨在对我国已完成的大样本随机对照临床试验治疗心脑血管病的效价作评估 ,向基层医生推荐疗效确切且价格合理的治疗药物。方法 本研究选择试验的标准是 :我国已完成的以心脑血管病为对象的大样本随机对照的临床试验 (急性试验样本数 1 0 0 0 0例以上 ,长期试验样本数 50 0例以上 )且以死亡或重要血管事件为研究终点的试验。评估指标是每治疗 1 0 0 0例患者多挽救患者生命的数量或预防血管事件的数量及预防 1例事件或多挽救 1例生命所支付的药费。结果 符合标准的 8个大样本随机对照临床试验入选 ,包括中国老年收缩期高血压试验、上海硝苯地平老年高血压试验、成都高血压干预试验、中国脑卒中后抗高血压治疗研究、中国心脏研究 I、中国急性缺血性脑卒中试验、降压治疗预防脑卒中再发研究的中国区结果、阿替洛尔与依那普利心肌梗死二级预防研究。本文分析表明用钙拮抗剂治疗高血压患者 1 0 0 0例 ,平均每年可预防脑卒中事件 8～ 1 1例 ,每预防脑卒中事件 1例 ,平均每年药费大约 2 4 0 0～ 1 0 0 0 0元 ;用利尿剂或ACE抑制剂治疗脑血管病患者 1 0 0 0例 ,平均每年可预防脑卒中事件 1 1～ 2 3例 ,每预防脑卒中事件 1例 ,平均每年药费 2 3 0 0 0～80 0 0 0元 ;用阿替洛尔或依那普利治疗心肌梗死
Objective This article aims to evaluate the efficacy of cardiovascular trials in China in a large randomized controlled clinical trial of cardio-cerebrovascular disease, and to recommend specific and reasonably priced therapeutic drugs to primary care physicians. Methods The standard of choice test in this study was: the randomized, controlled clinical trial of large sample of cardiovascular and cerebrovascular diseases in our country (more than 100 000 acute cases and more than 50 0 long-term experimental cases) And the death or major vascular events as the end of the trial. The assessment index is the number of patients who save more than one hundred patients per treatment, the number of prevention of vascular events, and the cost of preventing one incident or saving more lives for one life. Results A total of 8 large randomized controlled trials were included, including Chinese elderly systolic hypertension test, Shanghai Nifedipine Elderly Hypertension Trial, Chengdu Hypertension Intervention Trial, Chinese Antihypertensive Therapy after Stroke, Chinese Heart Study I, China Acute Ischemic Stroke Trial, Antihypertensive Therapy for Prevention of Recurrent Cerebral Stroke in China, Second A Prevention Study of Atenolol and Enalapril Myocardial Infarction. This analysis shows that calcium antagonists in the treatment of hypertension in 100 cases, the average annual prevention of stroke events 8 to 11 cases, each stroke prevention event in 1 case, the average annual drug costs of about 240 ~ 1 0 100 cases of patients with cerebrovascular disease treated with diuretics or ACE inhibitors, the average annual prevention of stroke events 1 1 ~ 2 3 cases, 1 case of prevention of stroke, the average annual drug 2 3 0 0 0 0 0 0 0 0 0 0 0 yuan; atenolol or enalapril treatment of myocardial infarction