Yeo W W, Ramsay L E
Department of Medicine & Pharmacology, Royal Hallamshire Hospital, Sheffield, UK.
J Hum Hypertens. 1990 Oct;4(5):517-20.
In a cohort of 136 hypertensive patients started consecutively on enalapril the incidence of persistent dry cough by life-table analysis was 14.6% (95% CI 10.2-19.0%). The incidence in women (19.2%; 95% CI 11.3-27.1%) was twice that in men (9.7%; 95% CI 6.6-12.8%). Dry cough was unrelated to age, smoking habit, renal function, or the dose and duration of enalapril treatment. In one half of patients who developed cough enalapril had to be stopped. The incidence of withdrawal due to cough was 6.0% (95% CI 4.5-7.5%), and cough was by far the most common reason for discontinuing enalapril treatment. Reviewing previous studies of enalapril-induced cough, it is evident that postmarketing surveillance studies have grossly underestimated the incidence and importance of this side-effect. Surveys in hospital clinics have slightly underestimated the true incidence through failure to use life-table methods of analysis.
在一组136例连续开始使用依那普利的高血压患者中，通过寿命表分析得出持续性干咳的发生率为14.6%（95%可信区间为10.2 - 19.0%）。女性的发生率（19.2%；95%可信区间为11.3 - 27.1%）是男性（9.7%；95%可信区间为6.6 - 12.8%）的两倍。干咳与年龄、吸烟习惯、肾功能或依那普利治疗的剂量及疗程无关。在出现咳嗽的患者中，有一半不得不停用依那普利。因咳嗽而停药的发生率为6.0%（95%可信区间为4.5 - 7.5%），而且咳嗽是停用依那普利治疗最常见的原因。回顾以往关于依那普利诱发咳嗽的研究，很明显上市后监测研究严重低估了这种副作用的发生率和重要性。医院门诊的调查由于未采用寿命表分析方法而略微低估了实际发生率。
