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目的分析１３５９７例急性心肌梗死（ＡＭＩ）患者心电图特征及卡托普利的作用。方法１３５９７例ＡＭＩ患者随机接受卡托普利或安慰剂治疗４周，分析心电图的特点及治疗效果。结果１３５９７例可疑ＡＭＩ心电图分类诊断为束支阻滞５２２例（３．８％），前壁梗死６６６０例（４９．０％），下壁梗死４１７８例（３０．７％），前下壁梗死１１５０例（８．５％），其他心电图变化１０８７例（８．０％）。基础血压水平下壁梗死者最低，随机治疗前心力衰竭发生率在束支阻滞和前下壁梗死者中较高，而Ⅱ～Ⅲ度房室传导阻滞（房室阻滞）、窦性心动过缓、收缩压＜１００ｍｍＨｇ的发生频率在下壁梗死者中最高。随机治疗４周，束支阻滞和前下壁梗死者心力衰竭、心室颤动（室颤）、其他类型心电图变化者心跳骤停、休克、低血压发生率均较高，束支阻滞与下壁梗死者房室阻滞发生率较高，后者低血压发生率最高。治疗４周，卡托普利组与安慰剂组比较，显著减少了前壁梗死者的心力衰竭发生率（１７．５％ｖｓ１９．９％，Ｐ＝０．０１）及室颤发生率（２．８％ｖｓ３．９％，Ｐ＝０．０１），明显减少了前壁梗死者总病死率（８．６％ｖｓ１０．２％，Ｐ＝０．０２），减少１６．１％；束支阻滞者病死率（２１．８％?
Objective To analyze the characteristics of electrocardiogram and the effect of captopril in 13 597 patients with acute myocardial infarction (AMI). Methods A total of 13597 patients with AMI were randomly assigned to receive either captopril or placebo for 4 weeks to analyze the characteristics of electrocardiogram and its therapeutic effect. Results The diagnosis of 13 597 suspicious AMIs was classified as 522 cases (3.8%) of bundle branch block, 6660 cases (49.0%) of anterior wall infarction, 4178 cases (30.7%) of inferior wall infarction, 1150 cases (8.5%), other 1088 cases of ECG changes (8.0%). Baseline blood pressure was lower in inferior wall infarction, and the incidence of heart failure prior to randomization was higher in patients with bundle branch block and anterior inferior wall infarction, whereas grade II-III AV block (atrioventricular block), sinus Bradycardia, systolic blood pressure <100mmHg occurred in the highest frequency of infarction in the inferior wall. 4 weeks of random treatment, bundle branch block and anterior inferior wall infarction, heart failure, ventricular fibrillation (VF), other types of ECG changes were cardiac arrest, shock, hypotension were higher incidence of bundle branch block and the next Wall infarction with a higher incidence of atrioventricular block, the latter the highest incidence of hypotension. After 4 weeks of treatment, the incidence of heart failure (17.5% vs 19.9%, P = 0.01) and the incidence of ventricular fibrillation (2%) in the captopril group were significantly lower than those in the placebo group .8% vs3.9%, P = 0.01), significantly reduced the total case fatality rate of anterior wall infarction (8.6% vs10.2%, P = 0.02), decreased by16.1% Blockage mortality (21.8%?