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本试验目的是评估血管紧张素转换酶抑制剂（ＡＣＥＩ）卡托普利对急性心肌梗塞（ＡＭＩ）患者早期病死率及并发症的影响。采用多中心随机双盲安慰剂对照临床试验方法，选择发病３６小时内的ＡＭＩ住院患者，随机口服卡托普利（１２．５ｍｇ，日三次）或相匹配的安慰剂，治疗４周。卡托普利治疗组（ｎ＝７４６８例）与安慰剂对照组（ｎ＝７４９４例）患者基础临床特征和治疗组相似，两组结果有可比性。治疗组４周总病死率（９．１％）低于对照组（９．７％）（Ｐ＝０．１９），治疗组与对照组比较，心力衰竭发生率（１７．０％ｖｓ１８．７％）减少９．５％（Ｐ＝０．０１）；联合终点事件（２１．５％ｖｓ２３．１％）减少７．２％（Ｐ＝０．０２）；休克（４．９％ｖｓ４．４％）与低血压（１６．１％ｖｓ１０．９％）分别增加１０．７％（Ｐ＝０．１１）与３８．５％（Ｐ＝０．０００１）；前壁梗塞者病死率（８．６％ｖｓ１０．２％）减少１７．０％（Ｐ＝０．０２）；基础心率≥６０次／分者病死率（９．２％ｖｓ１０．７％）减少１５．１％（Ｐ＝０．０１），≥１００次／分者（１７．２％ｖｓ２４．９％）减少３６．６％（Ｐ＝０．０００１）。结论：卡托普利早期治疗ＡＭＩ是安全和有益的，尤对?
The purpose of this trial was to evaluate the effect of captopril, an angiotensin converting enzyme inhibitor (ACEI), on early mortality and complications in patients with acute myocardial infarction (AMI). A multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted in which AMI hospitalized patients within 36 hours of onset were randomized to receive either captopril (12.5 mg three times daily) or matched placebo for 4 weeks. Captopril treatment group (n = 7468 patients) and placebo control group (n = 7494 patients) basic clinical features and treatment group similar to the two groups of comparable results. The 4-week overall mortality (9.1%) in the treatment group was lower than that in the control group (9.7%) (P = 0.19). The incidence of heart failure in the treatment group was 17.0% vs 18.7 %) Decreased by 9.5% (P = 0.01); combined endpoint decreased by 7.2% (21.5% vs 23.1%) (P = 0.02) %) And hypotension (16.1% vs10.9%) increased by 10.7% (P = 0.11) and 38.5% (P = 0.0001) (P = 0.02). The reduction of heart rate ≥ 60 beats / minute (9.2% vs 10.7%) was 15.1% (P = 0. 01), with a decrease of 36.6% (P = 0.0001) ≥100 beats / minute (17.2% vs 24.9%). Conclusions: Captopril early treatment of AMI is safe and beneficial, especially?