急性脑梗死患者的心脏自主神经功能及心功能变化研究

摘要

Objective To evaluate the prognosis and state of illness by studying the cardiac autonomic nervous function and heart function in patients with acute cerebral infarction. Methods HRV and LVEF of 89 patients with the first onset of acute cerebral infarction(observation group) and 80 healthy people(control group) were detected, ECG changes of different parts and prognosis in all patients were observed, HRV and LVEF of two groups were analyzed comparatively. Results ECG change rate was 65.1% in patients with acute cerebral infarction, ECG change rate of brainstem lesions was significantly higher than basal ganglia, thalamic lesions and brain lobes, cortical lesions(P <0.05), ECG change rate of basal ganglia, thalamic lesions was higher than brain lobes, cortical lesions. HF, LF, TF, SDNN, RMSSD and LVEF of observation group were lower than control group significantly(P <0.05). 4 patients with ECG changes died, prognosis in patients with ECG changes was poor than patients without ECG changes, HRV and LVEF was lower in patients with ECG changes. Conclusion The closer of Infarction focus and cardiovascular center, the more ECG changes, HRV and LVEF decreases with cerebral infarction exacerbation.%目的：研究脑梗死患者的心脏自主神经功能及心功能变化情况，以评估病情及预后。方法检测我院首发急性脑梗死的89例患者(观察组)及80例健康体检者(对照组)的心率变异性(HRV)及左室射血分数(LVEF)，并观察急性脑梗死发生不同部位心电图发生改变的情况及预后，同时比较分析两组受检者的心率变异性及左室射血分数检测值。结果急性脑梗死患者中，心电图变化的发生率为65.1%，脑干病变的心电图改变发生率显著高于基底节、丘脑病变及脑叶、皮质病变(P <0.05)，而基底节、丘脑病变的心电图改变发生率也略高于脑叶、皮质病变。且观察组的HF、LF、TF、SDNN、RMSSD、LVEF均低于对照组(P <0.05)。同时，4例心电图发生变化的脑干病变患者在观察期间死亡，其余心电图发生变化的患者预后较未出现心电图变化者较差，HRV各项指标及LVEF值降低明显。结论梗死病灶距离心血管中枢越近，心电图发生改变的几率越大，且HRV各项指标及EF值随着脑梗死病情的加重而逐渐下降。