Bastian B C, Macfarlane P W, McLauchlan J H, Ballantyne D, Clark P, Hillis W S, Rae A P, Hutton I
Am Heart J. 1980 Dec;100(6 Pt 2):1017-22. doi: 10.1016/0002-8703(80)90207-0.
One hundred forty-six patients with recent acute myocardial infarction were grouped at random into those treated with tocainide, an oral analogue of lignocaine, or placebo and followed up for 6 months. In addition to standard investigations, a 24-hour ambulatory taped ECG recording was obtained prior to randomization and thereafter at 2, 8, 16, and 24 hours after discharge. The ECGs were analyzed by means of an automated, computerized reporting system. Forty-two patients had significant ventricular arrhythmias, 10 of whom had effective plasma levels of tocainide compared with 27 patients on placebo (P < 0.005). In the placebo patients with increasing mobilization there was a consistent rise in the number of ventricular ectopic beats per day. There was no such increase in the tocainide patients (P < 0.01). Side effects were few and the incidence of central nervous system side effects was similar in both the tocainide and placebo groups. There was no conclusive evidence of myocardial depression, heart rate and blood pressure being unchanged over the 6-month period. Although ventricular arrhythmias were suppressed, the number of patients in the study was too small to draw conclusions regarding the mortality rate.
146例近期发生急性心肌梗死的患者被随机分为两组，一组接受利多卡因的口服类似物妥卡尼治疗，另一组接受安慰剂治疗，并随访6个月。除了标准检查外，在随机分组前以及出院后2、8、16和24小时获取24小时动态心电图记录磁带。通过自动化计算机报告系统对心电图进行分析。42例患者发生显著室性心律失常，其中10例患者的妥卡尼血浆水平有效，而安慰剂组有27例（P<0.005）。在安慰剂组中，随着活动增加，每天室性早搏数量持续上升。妥卡尼组未出现此类增加（P<0.01）。副作用较少，妥卡尼组和安慰剂组中枢神经系统副作用的发生率相似。没有确凿证据表明存在心肌抑制，在6个月期间心率和血压未发生变化。虽然室性心律失常得到抑制，但该研究中的患者数量过少，无法就死亡率得出结论。
