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近年把心肌梗塞(MI)划分为Q波型和非Q波型。尽管非Q波型MI的心肌坏死数量较少,住院死亡率比Q波型低,早期预后好,然而,长期存活率与Q波型相似,甚至更短。现已证明非Q波型MI病人更易发生再梗塞。由于β阻滞剂对非Q波型病人未显示疗效,作者选用钙拮抗剂硫氮(?)酮(Diltiazem)用于预防非Q波MI早期再梗塞的研究,并对药物的预防效果作出评价。方法:9所医疗中心共576例非Q波型MI患者作随机双盲对照研究,其中硫氮(?)酮组287例,安慰剂组289例,两组病人临床和实验室资料相类似。治疗开始于非Q波型MI发作后24-72小时,两组病人首次分别服硫氮(?)酮(每片30毫克)和安慰剂1片,第二次各服2片,此后各服3片,每天4次,直至第14天。也允许同(?)用β阻滞剂、硝酸
In recent years, myocardial infarction (MI) is divided into Q wave and non Q wave. Although non-Q-wave MI has a small number of myocardial necrosis, in-hospital mortality is lower than in Q-wave and early prognosis is good. However, long-term survival is similar to or even shorter than Q wave. It has been demonstrated that non-Q-wave MI patients are more prone to re-infarction. Because beta blockers do not show efficacy in non-Q wave patients, we selected the Diltiazem, a calcium antagonist, for the prevention of non-Q wave MI early reperfusion and evaluated the prophylactic effect of the drug . METHODS: A total of 576 non-Q-wave MI patients from 9 medical centers were randomized, double-blind controlled trials. Among them, 287 patients received sulfonylurea and 289 patients received placebo. Clinical and laboratory data were similar between the two groups. Treatment began 24-72 hours after the onset of non-Q-wave MI, and for the first time, patients in both groups were given 1 mg of thiamin (30 mg each) and placebo, 2 tablets each for the second time, and thereafter 3 tablets, 4 times daily until the 14th day. Also with (?) With beta blockers, nitric acid