目的　比较早期和长期卡托普利治疗对≥ 6 5岁和 <6 5岁急性心肌梗死 (心梗 )患者生存率的影响。　方法　根据是否早期及长期卡托普利治疗 ,将 82 2例首次心梗 72h内入院患者分为<6 5岁卡托普利组 2 0 9例、≥ 6 5岁卡托普利组 2 6 9例 ,<6 5岁对照组 131例、≥ 6 5岁对照组 2 13例。　结果　住院期 (1～ 42d) <6 5岁卡托普利组死亡 8例 (3 83% ) ,<6 5岁对照组死亡 10例 (7 6 3% ) ,差异无显著性 (P >0 0 5 ) ;≥ 6 5岁卡托普利组死亡 2 5例 (9 2 9% ) ,≥ 6 5岁对照组死亡 5 2例(2 4 41% ) ,差异有显著性 (P <0 0 0 0 1)。卡托普利治疗患者住院期心原性死亡与年龄相关 (P =0 0 0 0 2 ) ,随访 1 3～ 5 4 0个月表明 ,心原性死亡与年龄关系不密切 ;<6 5岁卡托普利组 15 8例中猝死 3例 (1 9% ) ,<6 5岁对照组 97例猝死 11例 (11 4% ,P <0 0 1) ;≥ 6 5岁卡托普利终访 192例中猝死 7例(3 6 % ) ,≥ 6 5岁对照组终访 12 8例中猝死 2 5例 (19 5 % ,P <0 0 1)。≥ 6 5岁和 <6 5岁卡托普利组心源性事件发生也低于相应对照组 (P <0 0 1)。　结论　卡托普利治疗急性心梗作用住院期有年龄差异 ,而长期应用改善预后作用无年龄差异。 Objectives To compare the effects of early and long-term captopril treatment on survival rates in patients 65 years of age and <65 years of acute myocardial infarction (MI). Methods According to whether the treatment of early and long-term captopril, 82 2 patients admitted within 72 hours of first myocardial infarction were divided into <65 years of captopril group, 209 cases, ≥ 65 years of captopril group 26 9 cases, 131 cases in <65 years old control group and 213 cases in control group> 65 years old. Results 8 cases (3 83%) in the captopril group were less than 65 years old in the hospitalization period (1-42 days), and 10 cases (76.3%) died in the control group <6.5 years old, with no significant difference (P> 0 (P <0 0); 25 cases (952%) died of captopril in the group of ≥65 years old and 52 cases (2441%) died in the group of ≥65 years old, the difference was significant 0 0 1). Captopril treatment of hospitalized patients with age-related cardiac death and age (P = 0.00002), followed up for 1-350 months showed that the relationship between cardiomyogenic death and age is not close; <6 5 years old Captopril group 15 cases of sudden death in 3 cases (19%), <6 5-year-old control group of 97 cases of sudden death in 11 cases (114%, P <0.01); ≥ 65 years of captopril Among 192 cases, 7 cases were sudden death (36%), and in the control group of 65 years of age, there were 25 cases (195%, P <0.01) of sudden death in 12 8 cases. The incidence of cardiac events ≥65 years and <65 years of captopril group was also lower than that of the corresponding control group (P <0.01). Conclusion Captopril treatment of acute myocardial infarction has different age of hospitalization, and long-term use to improve the prognosis of no difference in age.