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药理学浓度镁离子的心血管作用包括冠脉和全身血管舒张、血小板抑制及抗心律失常效应。已有报道在实验性缺血和再灌流模型,镁对心肌组织有保护作用。几个小样本临床试验提示,对可疑急性心肌梗塞于急性期静脉注入镁盐可降低早期死亡率,但尚无大样本试验作出结论。鉴此,作者进行随机双盲对照研究,给疑诊急性心肌梗塞的2316例患者随机给予硫酸镁静注(8mmol 于5分钟注完,随后65mmol 于24小时注完)或生理盐水。早期转归的检测是根据28天死亡率,这在99.3%的病例中已查明,对两组的预后因素已作平衡处理。分析全部死亡原因,镁治疗组死亡率为7.8%,而安慰剂组为10.3%(2P=0.04),镁治疗组相对降低24%(95%可信限1%～43%)。
Pharmacological Concentrations The cardiovascular effects of magnesium ions include coronary and systemic vasodilation, platelet inhibition and anti-arrhythmic effects. It has been reported that in experimental ischemia and reperfusion models, magnesium has a protective effect on myocardial tissue. Several small-scale clinical trials suggest that injecting magnesium salts into the acute phase of suspicious acute myocardial infarction may reduce early mortality, but no large-scale trials have yet concluded. As a result, the authors conducted a randomized, double-blind, controlled study of 2,316 patients with suspected acute MI who were randomized to receive intravenous magnesium sulfate (8 mmol, 5 min, followed by 65 mmol, 24 h) or saline. Early outcome testing is based on a 28-day mortality rate, which has been identified in 99.3% of cases, and the prognostic factors in the two groups have been balanced. The overall cause of death was analyzed. The mortality rate was 7.8% in the magnesium-treated group compared to 10.3% in the placebo group (2P = 0.04) and 24% in the magnesium-treated group (95% confidence limit, 1% to 43%).