Wilde M I, Bryson H M, Goa K L
Adis International Limited, Auckland, New Zealand.
Pharmacoeconomics. 1994 Aug;6(2):155-82. doi: 10.2165/00019053-199406020-00008.
Enalapril is an angiotensin converting enzyme (ACE) inhibitor with an established clinical profile. In patients with symptomatic heart failure, enalapril reduces overall mortality, death from progressive heart failure and hospitalisation rates. In those with asymptomatic left ventricular dysfunction, enalapril decreases the combined risk of death and development of heart failure, and the risk of death and hospitalisation. The effects of enalapril in reducing hospitalisation rates in symptomatic patients translate into net savings in healthcare costs in heart failure. Enalapril also produces modest benefits in quality-of-life (QOL) parameters in patients with symptomatic heart failure as shown in well controlled studies. Its effects appear similar to those of hydralazine plus isosorbide dinitrate. The influence of enalapril on quality of life in patients with asymptomatic disease is minimal but not deleterious. Enalapril generally either maintains or slightly improves quality of life from baseline in patients with mild to moderate hypertension. The drug appears to have a QOL profile that is more favourable than that of propranolol and similar to those of most other comparator drugs, as assessed by subjective measures of quality of life. Clarification is required of its QOL profile relative to that of captopril, in view of conflicting results in the literature. The effects of enalapril on cognitive and psychomotor function appear to resemble those of comparator agents. Thus, enalapril has modest beneficial effects on the quality of life of patients with symptomatic heart failure, while generally maintaining quality of life in patients with asymptomatic left ventricular dysfunction or mild to moderate hypertension. Enalapril is a cost-effective treatment in heart failure that would be expected to yield considerable cost savings in this therapeutic area.
依那普利是一种具有既定临床特征的血管紧张素转换酶（ACE）抑制剂。在有症状性心力衰竭的患者中，依那普利可降低总死亡率、因进行性心力衰竭导致的死亡率以及住院率。在无症状性左心室功能不全的患者中，依那普利可降低死亡和心力衰竭发生的联合风险，以及死亡和住院风险。依那普利在降低有症状患者住院率方面的作用转化为心力衰竭医疗成本的净节约。如严格对照研究所示，依那普利对有症状性心力衰竭患者的生活质量（QOL）参数也有适度益处。其效果似乎与肼屈嗪加硝酸异山梨酯相似。依那普利对无症状疾病患者生活质量的影响很小，但并无有害影响。依那普利通常可维持或轻微改善轻度至中度高血压患者的生活质量，使其从基线水平有所提高。通过生活质量的主观测量评估，该药物的生活质量特征似乎比普萘洛尔更有利，且与大多数其他对照药物相似。鉴于文献中的结果相互矛盾，需要进一步明确其相对于卡托普利的生活质量特征。依那普利对认知和精神运动功能的影响似乎与对照药物相似。因此，依那普利对有症状性心力衰竭患者的生活质量有适度益处，同时通常维持无症状性左心室功能不全或轻度至中度高血压患者的生活质量。依那普利是心力衰竭治疗中一种具有成本效益的治疗方法，预计在该治疗领域可节省大量成本。
