103例急性脑血管病患者的心电图改变与预后相关性分析

摘要

Objective To observe changes of electrocardiograms (ECGs) in 103 patients with acute cerebrovascular disease and analyze the relationship with the prognosis.Methods Clinical data of 103 patients with acute cerebrovascular disease trea‐ted in our hospital were analyzed retrospectively ,all patients were definitely diagnosed by head CT and/or magnetic resonance imaging (MRI). We analyzed examination results of ECGs comparatively.Results 62 cases (60.2% ) had abnormal ECGs ,25 cases(51.0% ) with abnormal ECGs among 49 cerebral infarction patients;there were 46 patients with cerebral hemorrhage , and among who 30 cases(65.2% ) has abnormal ECGs ;and 8 patients suffered subarachnoid hemorrhage with 7 cases having abnormal ECGs ;the abnormal rate of ECGs in patients with subarachnoid hemorrhage patients was significantly higher than that with cerebral infarction and cerebral hemorrhage (P<0.05). Major demonstrations of abnormal ECGs included the chan‐ges in ST‐T ,extension of Q‐T duration ,arrhythmia ,myocardial ischemia ,changes in T wave ,abnormal Q wave ,obvious U wave ,etc. Abnormal ECGs were associated with lesion positions. The abnormal rate of ECGs in patients with lesions at thala‐mus was significantly higher than that at other places (P<0.05). 8 patients with normal ECGs died (12.9% ) ,and 2 patients with abnormal ECGs died (4.9% ) ,the difference was statistically significant (P< 0.05). 30 cases had abnormal ECGs (83.33% ) among 36 patients suffered from unconsciousness ,the rate of abnormal ECGs in patients with consciousness was 47.76% (32/67) ,with significant difference(P<0.01).Conclusion Patients with acute cerebrovascular disease have higher rate of abnormal ECGs and have various types of abnormality ,the changes in ECGs can be considered as one of important inde‐xes to judge condition and prognosis. We should strengthen the acknowledge of abnormal ECG and take comprehensive meas‐ures to improve the prognosis of cerebrovascular disease.%目的：观察103例急性脑血管病患者的心电图改变情况，分析其与预后的关系。方法对我院2014‐01—10收治的103例急性脑血管病患者的临床资料进行回顾性分析，所有患者均经头颅C T和（或）磁共振成像（M RI ）检查确诊为急性脑血管病患者，对比心电图检查结果。结果103例患者中心电图异常62例，异常率60.2％；其中49例脑梗死患者心电图异常25例（51.0％），46例脑出血患者心电图异常30例（65.2％），8例蛛网膜下腔出血患者心电图异常7例（87.5％），蛛网膜下腔出血患者心电图异常率明显高于脑梗死和脑出血患者（P＜0.05）；心电图异常主要表现为ST‐T 改变、Q‐T间期延长、心律失常、心肌缺血、T波改变、异常Q波、明显U波等。心电图异常与病变部位有关，病变位于丘脑患者心电图异常率显著高于其他部位（P＜0.05）；心电图异常患者死亡8例（12.9％），心电图正常患者死亡2例（4.9％），差异有统计学意义（P＜0.05）。出现意识障碍36例，心电图异常率83.33％（30／36），无意识障碍患者的心电图异常率47.76％（32／67），差异有统计学意义（ P＜0.01）。结论急性脑血管病的心电图异常率较高，且异常类型较多，心电图变化可作为判断病情及估计预后的重要指标之一，临床救治脑血管病患者时，应加强心电图异常的认识，采取有效综合治疗措施，改善脑血管病预后。