急性脑卒中患者发生脑心综合征的相关分析及其预后研究

摘要

Objective To investigate the correlation between the cerebrocardiac syndrome (CCS) of severe type and prediction of prognosis of patients with neurosurgery .Methods Myocardial zymogram levels were measured in course of development of 120 ca‐ses of Acute Stroke(AS) that were confirmed diagnosis by brain computerized tomography (CT) .ultrasoundcardiogram(UCG)and electrocardiogram(ECG)were used to dectect Segmental Wall Motio Abnormalities (SWMA) .Results For 120 patients with AS , the specimens include 38 cases(76 .0% )of T‐wave change and 12 cases(24 .0% )of ST‐segment depression in 50 cases of ST‐T seg‐ment change ,7 cases of arrhythmia and adnormal cardiac electrical conduction .24 cases of SWM A ,32 cases(26 .7% ) of raised CK‐MB ,35 patients could be recovered to normal of ECG after active treatment .17cases of ECG improve markedly ,18 cases of ECG un‐improved ,15 cases of myocardial enzymes normally ,8 cases of myocardial enzymes improve markedly20 cases of death .Conclusion Hypertension is a risk factor of CCS ,correlation between ST‐T segment and SWMA as well as myocardial enzymes and myocardial damagein CCS was statistically analyed .%目的：研究急性脑卒中（CVS）患者发生脑心综合征（CCS）及其预后相关性。方法对120例通过脑CT扫描确诊的CVS患者分别测定在发病不同时间的心肌酶谱水平，并行超声心动图检查，观察节段性室壁运动异常（SWM A ），并进行十二导联心电图（ECG）检查，分析检查结果。结果本组120例患者中，50例（41．6％）发生ST‐T波改变，其中38例（76．0％）显示T波改变，而12例（24．0％）显示ST段压低；7例患者观察到心律失常和心电传导异常；有24例患者观察到SWMA改变，肌酸激酶同工酶（CK‐MB）升高者有32例（26．7％）。经积极治疗后，随着病情的好转35例ECG恢复正常，17例ECG明显好转，无改善者18例；15例患者心肌酶谱恢复正常，8例患者明显好转；共20例患者死亡。结论高血压是CCS的危险因素，ST‐T改变和SWM A改变与CCS有一定联系，心肌酶谱异常和CCS患者心肌损伤具有一定相关性。