急性脑梗死患者心电图特征与病情分型及其预后状况的关系

doi:10.7517/issn.1674-0475.190911

摘要/Abstract

摘要： 为探讨急性脑梗死患者心电图特征与病情分型及其预后状况的关系，选择2016年1月~2019年6月期间本院神经内科住院部收治的急性脑梗死患者110例作为研究对象，全部患者采用心电图检查。急性脑梗死患者心电图异常率为72.73%，其中缺血性ST-T改变占45.00%，窦性心动过速和室性早搏各占11.25%，心房颤动占7.50%，房性早搏和左心室肥厚各占6.25%。轻型组心电图异常率为52.63%，明显低于中型组的82.22%和重型组的85.19%，比较差异具有统计学意义（P<0.05）。大梗死灶组、小梗死灶组心电图异常率分别为88.89%和79.41%，明显高于腔隙性脑梗死组的41.94%，比较差异具有统计学意义（P<0.05）。心电图异常组死亡率明显高于心电图正常组，比较差异具有统计学意义（P<0.05）。提示急性脑梗死患者心电图异常主要表现为缺血性ST-T改变、窦性心动过速、室性早搏、心房颤动、房性早搏和左心室肥厚等，其异常率对病情分型及其预后状况具有重要的评估价值。

关键词: 急性脑梗死, 心电图, 病情分型, 预后

Abstract: To explore the relationship between ECG characteristics and disease classification and prognosis for patients with acute cerebral infarction, 110 patients with acute cerebral infarction admitted to neurology department of our hospital from January 2016 to June 2019 were selected as research objects. All patients were given electrocardiogram examination. The abnormal rate of ECG was 72.73%, including ischemic ST-T changes(45.00%), sinus tachycardia(11.25%), ventricular premature beats (11.25%), atrial fibrillation(7.50%), atrial premature beats(6.25%) and left ventricular hypertrophy (6.25%). The abnormal rate of ECG in the slight-group was significantly lower than those in the medium-group and the severe-group (P<0.05). The abnormal rate of ECG in the large and the small infarction groups were significantly higher than those of the lacunar cerebral infarction group (P<0.05). The mortality rate of abnormal ECG group was significantly higher than that of normal ECG group (P<0.05).In conclusion, ECG abnormalities in patients with acute cerebral infarction are mainly manifested as ischemic ST-T changes, sinus tachycardia, ventricular premature beats, atrial fibrillation, atrial premature beats and left ventricular hypertrophy, and the abnormal rate has important evaluating value for disease classification and prognosis.

Key words: acute cerebral infarction, ECG, disease classification, prognosis

中图分类号:

郭小云, 王金桃. 急性脑梗死患者心电图特征与病情分型及其预后状况的关系[J]. 影像科学与光化学, 2020, 38(2): 286-290.

GUO Xiaoyun, WANG Jintao. The Relationship Between Electrocardiogram Characteristics and Disease Classification, Prognosis for Patients with Acute Cerebral Infarction[J]. Imaging Science and Photochemistry, 2020, 38(2): 286-290.

参考文献

[1] 申倩, 祝楠波, 余灿清,等.中国成年人吸烟与心血管疾病发病风险的关联及其性别差异分析[J].中华流行病学杂志, 2018,39(1):8-15. Shen Q, Zhu N B, Yu C Q, et al.Sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults[J].Chinese Journal of Epidemiology, 2018,39(1):8-15.
[2] 包品, 宫玉霞.心房颤动对急性缺血性脑卒中患者静脉溶栓治疗后神经功能和预后的影响研究[J].实用心脑肺血管病杂志, 2017,25(9):25-28. Bao P,Gong Y X.Impact of atrial fibrilla on neurological function and prognosis in acute ischemic stroke patients treated by intravenous thrombolytic therapy[J].Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2017,25(9):25-28.
[3] 李婷婷, 张兆辉. 急性脑梗死后心电图异常及其相关危险因素分析[J]. 卒中与神经疾病, 2017,24(2):110-113. Li T T, Zhang Z H. Analysis arrhythmia of abnormal electrocardiogram and relative risk factors in patients with cerebral infarction[J]. Stroke and Nervous Diseases, 2017,24(2):110-113.
[4] 闭媛媛. 急性脑梗死患者不同梗死部位对心电图检测结果的影响[J]. 血栓与止血学, 2016,22(3):255-257. Bi Y Y. Research on influences of different infarction sites in patients with acute cerebral infarction on electrocardiogram examination results[J]. Chinese Journal of Thrombosis and Hemostasis, 2016,22(3):255-257.
[5] 中华医学会神经病学分会. 中华医学会神经病学分会脑血管病学组. 中国各类主要脑血管病诊断要点2019[J]. 中华神经科杂志, 2019,52(9):710-715. Chinese Society of Neurology, Chinese Stroke Society. Diagnostic criteria of cerebrovascular diseases in China (version 2019)[J]. Chinese Journal of Neurology, 2019,52(9):710-715.
[6] 吴钰珊, 韩伟华, 伍丽贞, 等. 急性脑梗死与脑出血患者心电图变化及其与预后的关系[J]. 广东医科大学学报, 2018,36(1):106-108. Wu Y S, Han W H, Wu L Z, et al. Relationship between electrocardiogram changes and prognosis in acute cerebral infarction and cerebral hemorrhage[J]. Journal of Guangdong Medical College, 2018,36(1):106-108.
[7] 美国国立卫生研究院. 美国国立卫生研究院脑卒中量表(NIHSS)简介[J]. 临床荟萃, 2009,24(8):685. National Institutes of Health. National Institute of Health stroke scale (NIHSS) introduction[J]. Clinical Focus, 2009,24(8):685.
[8] 夏鹏飞, 王伟, 邹亮, 等. 颅内未破裂动脉瘤介入术后微小脑梗死灶形成的危险因素分析[J]. 卒中与神经疾病, 2017,24(6):508-511. Xia P F, Wang W, Zhou L, et al. Risk factors of microembolism after endovascular coiling for unruptured intracranial aneurysms[J]. Stroke and Nervous Diseases, 2017,24(6):508-511.
[9] 张爱玲, 许珂, 邢海英, 等.心肾功能对急性脑卒中早期神经功能恢复的影响[J].中华神经科杂志, 2019,52(6):463-471. Zhang A L, Xu K, Xing H Y, et al.Effects of cardiac function and renal function on early neurological function recovery in patients with acute stroke[J].Chinese Journal of Neurology, 2019,52(6):463-471.
[10] 赵兰峰.脑血管疾病与心电图改变[J].首都医学院学报, 1989,10(2):155-157. Zhao L F.Cerebrovascular disease and ecg changes[J].Journal of Capital Medical College,1989,10(2):155-157.
[11] 张卫青. 不同部位脑梗死患者心电图异常与病情分型的相关性研究[J]. 中国实用神经疾病杂志, 2017,20(10):93-95. Zhang W Q. Study on the correlation between electrocardiogram abnormality and disease classification in patients with different cerebral infarction[J]. Chinese Journal of Practical Nervous Diseases, 2017,20(10):93-95.
[12] 甘起云. 老年急性缺血性脑梗死患者心电图ST-T变化及其临床应用价值[J]. 包头医学院学报, 2017,33(12):12-14, 21. Gan Q Y. Changes of ST-T in electrocardiogram in elderly patients with acute ischemic infarction and its relationship with the severity of illness[J]. Journal of Baotou Medical College, 2017,33(12):12-14, 21.
[13] 叶澄健, 蓝巧因, 吴志镛. 自发性脑出血早期继发心律失常105例心电图分析[J]. 按摩与康复医学, 2018,9(11):38-39. Ye C J, Lan Q Y, Wu Z Y. Electrocardiogram analysis of 105 cases of spontaneous intracerebral hemorrhage with early secondary arrhythmia[J]. Chinese Manipulation & Rehabilitation Medicine, 2018,9(11):38-39.
[14] 刘媛媛, 杨印东, 朱伟. 不同亚型急性脑梗死心电图和心肌标志物变化[J]. 牡丹江医学院学报, 2017,38(3):24-27. Liu Y Y, Yang Y D, Zhu W. Electrocardiogram and myocardial enzymes change analysis in different subtypes of acute cerebral infarction[J]. Journal of Mudanjiang Medical University, 2017,38(3):24-27.