Visser P J, Bredero A C, Hoekstra J B
Department of Internal Medicine, Diakonessenhuis Utrecht, Netherlands.
Neth J Med. 1995 Mar;46(3):156-65. doi: 10.1016/0300-2977(94)00066-i.
The trials reviewed in this study investigated the effect of intravenous magnesium on arrhythmias and mortality in acute myocardial infarction. Nine trials were carried out in the pre-thrombolytic era. They varied in set-up, number of patients, dose of magnesium, follow-up and the type of arrhythmias analyzed. Magnesium reduced mortality in most studies, but the reduction was significant in only three of them. Two meta-analyses of the smaller studies revealed a 55% reduction in mortality. In the LIMIT-2, in which 2300 patients were enrolled, magnesium reduced mortality significantly by 24%. The effect of magnesium on arrhythmias was less clear. Preliminary results of ISIS-4, in which magnesium among others was administered together with thrombolytic agents, did not provide evidence of benefit in patients with suspected myocardial infarction. At present there are no arguments for the use of magnesium in acute myocardial infarction.
本研究中所回顾的试验探讨了静脉注射镁对急性心肌梗死患者心律失常及死亡率的影响。九项试验是在溶栓治疗前的时代进行的。这些试验在研究设置、患者数量、镁的剂量、随访以及所分析的心律失常类型等方面存在差异。在大多数研究中，镁降低了死亡率，但只有三项研究中的降低幅度具有统计学意义。两项针对较小规模研究的荟萃分析显示死亡率降低了55%。在纳入2300例患者的LIMIT - 2试验中，镁显著降低了24%的死亡率。镁对心律失常的影响则不太明确。ISIS - 4试验的初步结果显示，在该试验中镁与溶栓药物等一同使用，并未证明对疑似心肌梗死患者有益。目前，没有理由在急性心肌梗死中使用镁。
