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背景 急性心肌梗死的死亡率和并发症发生率仍较高。心肌梗死后早期静脉使用硫酸镁可望限制梗死面积、预防严重心律失常、降低死亡率,是一种有希望的辅助治疗措施。多个早期的临床试验和Meta-分析证实,镁可降低死亡率,但是有一个大型的临床试验却证明其无效。目的 根据起病时间(<6小时,6+小时)、是否使用溶栓剂、镁的用量(<75mmol,75+mmol),分层评价静脉硫酸镁对急性心肌梗死患者死亡率和并发症发生率的影响。检索策略检索Cochrane对照试验注册资料库、MEDLINE和EMBASE,同时检索中文生物医学光盘以检出中文临床试验。所有数据库均从创刊检索到2002年前半年。选择标准 所有比较静脉硫酸镁与安慰剂的随机对照试验,在常规治疗的基础上不管是否使用溶栓治疗,只要报告了起病后35天内的死亡率和并发症发生率,语种不限。评价方法 设计表格提取合格文献的资料。随机对照试验的质量评估主要包括治疗措施的分配方法、受试对象和研究人员是否采用盲法、选择性偏倚的控制。由两名评价者独立选择文献、提取数据和评价文献的方法学质量。不同意见通过讨论解决,必要时咨询第三人。将检测发表偏倚、异质性和进行敏感性分析。采用比值比合成资料。
Background The incidence of acute myocardial infarction and complications is still high. Early intravenous use of magnesium sulfate after myocardial infarction is expected to limit the infarct size, prevent serious arrhythmia, reduce mortality, is a promising adjuvant therapy. Several early clinical trials and Meta-analysis confirmed that magnesium reduces mortality, but a large clinical trial proved ineffective. Objective To assess the mortality and complications of intravenous magnesium sulfate in patients with acute myocardial infarction according to the time of onset (<6 hours, 6 hours), whether or not to use thrombolytic agents and magnesium (<75 mmol, 75 + mmol) Rate of impact. RETRIEVAL STRATEGY Search Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE, and search Chinese biomedical CD-ROM for Chinese clinical trials. All databases were retrieved from the start of publication until the first half of 2002. SELECTION CRITERIA All randomized controlled trials comparing intravenous magnesium sulphate to placebo on any routine treatment with or without thrombolytic therapy should report as long as 35 days after onset of mortality and complication rates. Evaluation Method Design Form Extract qualified documents. The quality assessment of randomized controlled trials mainly includes the distribution of treatment measures, whether the subjects and researchers adopt the blind, selective bias control. Two reviewers independently selected documents, extracted data, and assessed the methodological quality of the literature. Disagreement is resolved through discussion and the third person is consulted if necessary. Post publication bias, heterogeneity, and sensitivity analysis will be tested. Using odds ratio synthetic data.