【作者】 卢才义；

【导师】 陶寿淇； 刘力生；

【作者基本信息】 中国协和医科大学 ， 心内科临床， 1990， 博士

【摘要】 用随机、双盲和安慰剂对照的方法对98例急性期心肌梗塞病人进行了口服转换酶抑制剂(captopril)治疗的预试验，结果表明，①所采用的随机分组方法效果良好；4周观察期间中途停药和中断服药24小时以上者仅各占5.1％；未发现与服用captopril有关的副作用；因此，在心肌梗塞急性期进行口服captopril治疗的大规模临床研究是可行的；②captopril轻度降低急性期心肌梗塞患者的血压(服6.25mg后2小时后平均下降10.2／4.5mmHg)，但并不增加持续性低血压的发生率，心率不增快；③心肌梗塞患者服用captopril后，血浆肾素活性更加升高，血管紧张素Ⅱ浓度下降，这些变化与对血压的影响相一致，④急性心肌梗塞后早期开始captopril治疗有减少心脏游离壁破裂发生率和减轻充血性心力衰竭及心源性休克程度的趋势，并有可能因此而降低心肌梗塞急性期病死率；③由于样本数尚少，本试验还不能证实captopril对急性心肌梗塞的确切疗效，有必要进行大规模的简单随机临床试验。更多还原

【Abstract】 A randomized, doubleblind and placebo-controlled pilot study was done on the use of converting enzyme inhibitor CAPTOPRIL in 98 patients in the early stage of acute myocardial infarction (AMI) with the purpose of testing the feasibility and justifiability of a large clinical trial on such therapy. The results of the study were as follows. ? The randomization method enhanced in this study was quite satisfactory. The interruption of the treatment protocol for more than 24 hours and the patient drop-out rates were only 5.1 percent each, and no side effects of captopril were observed, indicating that such a study can be carried out on large scale. ② Captopril slightly lowered blood pressure (average 10.2/4.5 mmHg) with minimal change of heart rate, but it did not increase the incidence of sustained hypotension. ③ Captopril further elevated the plasma renin activity and decreased the angiotensin II levels of the AMI patients, and such changes paralleled with the reduction of blood pressure. ④ Early captopril treatment tended to reduce the incidence of cardiac free wall rupture, and the severity of congestive heart failure and cardiogenic shock, therefore更多还原