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目的 :分析 AMI患者多中心双盲对照卡托普利临床试验中年龄因素对治疗效果的影响。方法 :将病人按不同年龄段分为四组 :<5 5岁 ,5 5～ 6 4岁 ,6 5～ 74,≥ 75 ,按分组描述其性别 ,病症 ,以及治疗后的结果。结果 :男性分别占 85 .6 % ,75 .4% ,6 7.2 % ,5 8.9%。高血压 ,糖尿病陈旧性心梗随年龄增长而增长 ,但≥ 75组却增加不多。基础收缩压随年龄增长而增加。治疗前心力衰竭事件亦随年龄增长而增加。卡托普利随机治疗 4周 ,各年龄段总死亡率随年龄增长而增加 (3.4% ,7.3% ,1 3.4% ,2 1 .6 % ) ,治疗组较安慰剂对照组后三组总死亡率分别减少 (7.8% ,6 .0 % ,1 0 .8% ) ;心力衰竭事件在第二组减少 1 5 .7% ,在第三组减少 1 1 .7% ;室颤发生率分别减少 6 .3% ,1 6 .0 % ,1 5 .7%和 1 6 .0 % ,但却明显增加了低血压 ,心源性休克和 2～ 3度房室传导阻滞的发生率。结论 :急性心梗危险性随年龄增长而增加 ;但卡托普利的早期治疗对各年龄段均有益
OBJECTIVE: To analyze the effect of age factors on the therapeutic effect in a multicenter, double-blind, captopril clinical trial of patients with AMI. Methods: The patients were divided into four groups according to different age groups: <5 5 years old, 5 5 ~ 6 4 years old, 6 5 ~ 74, ≥ 75, according to group sex, illness, and treatment results. Results: Men accounted for 85.6%, 75.4%, 62.2% and 59.9% respectively. Hypertension, diabetes, old myocardial infarction with age and growth, but not more than 75 groups increased. Basal systolic blood pressure increases with age. Heart failure before treatment also increased with age. Captopril was randomized for 4 weeks and the overall mortality rate increased with age (3.4%, 7.3%, 13.4%, 21.6%) in all age groups. The total deaths in the treatment group compared with the placebo-controlled group (7.8%, 6.0% and 1.08%, respectively). The incidence of heart failure decreased by 15.7% in the second group and decreased by 11.7% in the third group, and the incidence of ventricular fibrillation decreased 6 .3%, 16.0%, 15.7% and 16.0%, but significantly increased the incidence of hypotension, cardiogenic shock and 2 ~ 3 degree atrioventricular block. Conclusions: The risk of acute myocardial infarction increases with age; however, early treatment with captopril is beneficial for all age groups