Elliott H L, Meredith P A
Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland.
Am J Hypertens. 1996 Oct;9(10 Pt 2):71S-75S; discussion 87S-90S. doi: 10.1016/0895-7061(96)87755-7.
The trough-to-peak ratio for the response to an antihypertensive drug is a clinically meaningful parameter but only when the calculation has been derived from an appropriate and scientifically robust study. Since the methodological details have not been defined by any regulatory authority, several possible approaches have developed. The major apparent advantages of the intensive study of individual patients in the research unit setting are that the conditions of measurement can be standardized and an accurate account can be taken of the circadian variations in the responses to placebo and active drug treatment. The principal disadvantage is that it is an "artificial" environment that may, or may not, be directly relevant to routine clinical circumstances. Nevertheless, the values obtained with this approach to date are directly comparable to values obtained by the alternative approaches, such as ambulatory blood pressure measurements (provided that those are also well-conducted studies). Thus, using the trough-to-peak ratio not only appears valid but also permits the detailed study of individual patients and also lends itself to the incorporation of additional and confirmatory clinical pharmacological assessments.
抗高血压药物反应的谷峰比是一个具有临床意义的参数，但前提是该计算源自恰当且科学可靠的研究。由于尚无任何监管机构明确方法学细节，因此出现了几种可能的方法。在研究单位环境中对个体患者进行深入研究的主要明显优势在于，测量条件可以标准化，并且可以准确考虑到对安慰剂和活性药物治疗反应的昼夜变化。主要缺点是这是一个“人工”环境，可能与常规临床情况直接相关，也可能不相关。然而，迄今为止用这种方法获得的值可直接与通过其他方法（如动态血压测量，前提是这些也是开展良好的研究）获得的值进行比较。因此，使用谷峰比不仅似乎有效，而且还允许对个体患者进行详细研究，并且便于纳入额外的和确证性的临床药理学评估。
