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目的：评价可疑急性心肌梗死后静脉内使用链激酶、口服１个月阿司匹林或同时使用两种治疗对患者长期生存的影响。 设计：随机化、“２×２因素分析”、安慰剂对照试验。 背景：１６个国家４１７个医院参加此项研究。 对象：１９８５年３月至１９８７年１２月，随机选入１７１８７例可疑急性心肌梗死患者。对９５％患者生命状态的随访工作最迟在１９９０年１月１日前完成，对其中英国６２１３例患者最终随访至１９９７年中期完成。 干预措施：静脉内使用链激酶（１．５ＭＵ／小时）和口服阿司匹林（１６２ｍｇ／日，持续１个月）及对照使用安慰剂。 主要观察指标：１０年随访中各种原因的病死率，亚组分析以４年随访结果为基础。 结果：随机研究开始后０～３５天，１８４１例患者死亡，从第３６天至第１年底，９９１例患者死亡，第２至第４年，１４７８例患者死亡，第５至第１０年，１２３０例患者死亡。在０～３５天之间，分配到链激酶组的患者每千例中减少死亡人数２９例（９５％可信区间为２０～３８）。这种早期受益持续存在（从第３６天至第１０年末的病死率比值为０．９８（０．９２～１．０４）），在第４年和第１０年时，链激酶组的病死率仍然分别比对照组低２８‰（１４‰～４２‰）和２３?
PURPOSE: To evaluate the long-term survival of patients with suspicion of acute myocardial infarction intravenous streptokinase, oral aspirin 1 month or both. Design: Randomized, “2 × 2 factor analysis”, placebo-controlled trial. Background: 417 hospitals in 16 countries participated in the study. PARTICIPANTS: From March 1985 to December 1987, 17,187 patients with suspected acute myocardial infarction were randomly enrolled. Survival of 95% of patients was completed by January 1, 1990 no later than January 1, 1990, of which 6213 patients were eventually followed up from mid-1997 to mid-1997. Interventions: Streptokinase (1.5 MU / hour) and oral aspirin (162 mg / day for 1 month) were intravenously administered and placebo was administered as a control. MAIN OUTCOME MEASURES: Mortality for various causes at 10-year follow-up, subgroup analysis based on 4-year follow-up results. RESULTS: From 0 to 35 days after the start of the randomized study, 1841 patients died, from day 36 to end of year 1, 991 patients died, from 2 to 4 years, 1478 patients died, from 5 to 10 years, 1230 The patient died. Among 0-35 days, the number of deaths per 1000 patients assigned to streptokinase decreased by 29 (95% CI, 20-38). This early benefit persisted (mortality rate from day 36 to end of year 10 was 0.98 (0.92 to 1.04)). At the 4th and 10th years, the ratio of streptokinase The mortality rates were still 28 ‰ (14 ‰ ~ 42 ‰) and 23 ‰