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目的 比较早期和长期卡托普利治疗老年 (6 5～ 75岁 )和年轻 (≤ 6 4岁 )急性心肌梗死 (心梗 )患者作用差异。方法 82 2例首次心梗 72小时内入院患者中 ,根据是否早期及随访期持续卡托普利治疗 ,分为年轻治疗组 2 0 9例、老年治疗组 2 6 9例 ,年轻对照组 131例、老年对照组 2 13例。用Kaplan Meier法计算各组的生存率 ,同时用多因素分析测定影响治疗组生存率的因素 (包括年龄 )。结果 卡托普利治疗组患者的生存率与年龄相关 (P <0 0 0 1) ;其中住院期死亡年轻治疗组 8例 ,年轻对照组 10例 (3 83%vs 7 6 3% ,P >0 0 5 ) ;老年治疗组 2 5例 ,老年对照组 5 2例 (9 2 9%vs 2 4 4 1% ,RR =0 37,95 %CI:0 2 9～ 0 4 8;P <0 0 0 0 1)。随访期卡托普利治疗组的生存率与年龄不相关 (P >0 0 5 ) ;老年和年轻治疗组死亡和心性事件均低于相应对照组 (P <0 0 1)。结论 卡托普利治疗对急性心梗早期作用有年龄差异 ,对老年患者有明显的有益作用 ;而长期应用改善预后作用无年龄差异。
Objective To compare the effects of early and long-term captopril on the treatment of acute myocardial infarction (MI) in the elderly (65 to 75 years) and young (≤64 years). Methods Eighty-two patients admitted to hospital with first myocardial infarction within 72 hours were divided into two groups: young treatment group (209 cases), elderly treatment group (269 cases) and young control group (131 cases), according to whether early and follow- , Elderly control group 2 13 cases. Kaplan Meier method was used to calculate the survival rate of each group, while using multivariate analysis to determine the factors that affect the survival rate of the treatment group (including age). Results The survival rate of patients in captopril group was related to age (P <0.01). Among them, 8 were young in hospitalized group and 10 in young control group (383% vs 73.3%, P> There were 25 elderly patients in the treatment group and 52 elderly patients in the control group (9 2 9% vs 2 4 4 1%, RR 0 37 95% CI 0 2 9 0 48; P 0 0 0 0 1). The survival rate of captopril group was not related to age at follow-up (P> 0.05). The death and cardiac events in elderly and young treatment group were lower than those in corresponding control group (P <0.01). Conclusion Captopril treatment of acute myocardial infarction in the early role of age differences in elderly patients has a significant beneficial effect; and long-term use to improve the prognosis of the role of no age difference.