关键词：心肌梗死/药物疗法；血管紧张素转换酶抑制药
摘要 目的 探讨老年人急性心肌梗死(心梗)卡托普利治疗对预后的意义。 方法 631例首次急性心梗后72小时内入院无心源性休克老年患者中，361例早期及随访期持续卡托普利治疗(治疗组)，270例常规治疗(对照组)，比较两组住院期和随访期生存率的差异。 结果 住院期治疗组生存率(92.2%)显著高于对照组(78.9%，P<0.001)，卡托普利对前壁心梗作用较下壁心梗明显。随访期(第9周～第54个月末)第54个月末治疗组累积生存率(91.0%)显著高于对照组(74.0%，P<0.01)，心源性事件累积发生率(55.0%)低于对照组(72.0%，P<0.0001)
结论 老年人急性心梗后早期及持续卡托普利治疗对其预后具有益作用。
Beneficial effectsof captopril on the treatment and secondary prevention of acute myocardial infarction inelderly
Cai Xu, Shen Weifeng, Li Mingzhou, et al.Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025
Abstract Objective Toinvestigate the effects of captopril on early and long-term intervention of acutemyocardial infarction (AMI) in elderly. Methods Six hundred and thirty-one AMI elderly patients(60-75 years old)without cardiogenic shock hospitalized within 72 hours of symptoms were randomly allocatedto captopril treatment group (n=361), and conventional treatment as controls (n=270). Thesurvival and cardiac events in both groups were observed in hospital and during follow-up(54 months). Results In the captopril treatment group the survival was higher (92.2%)than in controls (78.9%,P<0.001) and more marked forthe patients with anterior MI (P<0.001) than thosewith inferior MI (P>0.05). Higher cumulativesurvival (91.0% vs. 74.0% ......
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