Feldstedt M, Boesgaard S, Bouchelouche P, Svenningsen A, Brooks L, Lech Y, Aldershvile J, Skagen K, Godtfredsen J
Coronary Care Unit, Herlev University Hospital, Denmark.
Eur Heart J. 1991 Nov;12(11):1215-8. doi: 10.1093/eurheartj/12.11.1215.
It has recently been suggested that intravenous infusion of magnesium may reduce mortality and the incidence of serious arrhythmias in patients with ischaemic heart disease and acute myocardial infarction. In the present double-blind, placebo-controlled study, 298 patients with suspected acute myocardial infarction were randomized to receive either intravenous magnesium chloride (80 mmol.24 h-1) or placebo. Infusions were started immediately after admission to the coronary care unit. One hundred and fifty patients received magnesium and 148 the placebo. Ischaemic heart disease was diagnosed in 244 patients. Acute myocardial infarction was observed among 83 patients in the magnesium group and 79 in the placebo group. Both treatment groups were comparable regarding sex, age, clinical status, previous cardiac disease and medication. Serum magnesium was significantly raised during magnesium infusion compared to placebo (P less than 0.01). Fatal events were only observed among patients with myocardial infarction, but neither the in-hospital mortality (magnesium: 12.1%; placebo 10.1%) nor the mortality after a follow-up period of 245 days (median observation time) was affected by magnesium substitution. Magnesium infusion was accompanied by a significantly increased incidence of atrioventricular conduction disturbances. The results suggest that patients suffering from acute ischaemic heart syndromes do not benefit from intravenous magnesium supplementation.
最近有人提出，静脉输注镁可能会降低缺血性心脏病和急性心肌梗死患者的死亡率及严重心律失常的发生率。在本项双盲、安慰剂对照研究中，298例疑似急性心肌梗死患者被随机分为两组，分别接受静脉注射氯化镁（80 mmol·24 h⁻¹）或安慰剂。在进入冠心病监护病房后立即开始输注。150例患者接受镁治疗，148例接受安慰剂治疗。244例患者被诊断为缺血性心脏病。镁组有83例患者发生急性心肌梗死，安慰剂组有79例。两个治疗组在性别、年龄、临床状况、既往心脏病史和用药方面具有可比性。与安慰剂相比，输注镁期间血清镁显著升高（P＜0.01）。仅在心肌梗死患者中观察到致命事件，但镁替代治疗对住院死亡率（镁组：12.1%；安慰剂组10.1%）和245天随访期（中位观察时间）后的死亡率均无影响。输注镁伴随着房室传导障碍发生率的显著增加。结果表明，患有急性缺血性心脏综合征的患者无法从静脉补充镁中获益。
