脑卒中患者急性期心肌酶与心电图QT离散度的变化及意义

目的探讨脑卒中急性期心肌酶、QT离散度(QTd)的变化及意义。方法选择71例脑出血、78例脑梗死患者和57例健康老年人,分别测定各组心肌酶、QTd,并进行比较。结果与对照组比较,脑出血组、脑梗死组天冬氨酸转移酶(AST)、乳酸脱氢酶(LDH)、肌酸磷酸激酶(CK)、肌酸磷酸激酶同工酶(CK-MB)、QTd均明显升高或延长,有显著性差异(P均<0.05或0.01);脑出血组和脑梗死组比较AST、LDH、CK显著升高,有显著性差异(P均<0.01),CK-MB、QTd无显著性差异(P>0.05)。与轻度组比较,除中度组AST虽升高但无显著性差异外(P>0.05),中、重度组各指标均明显升高或延长,有显著性差异(P<0.05或0.01)。与中度组比较,重度组AST、CK显著升高,有显著性差异(P均<0.05),LDH、CK-MB、QTd无显著性差异(P均>0.05)。与无意识障碍组比较,意识障碍组AST、LDH、CK、CK-MB、QTd均明显升高或延长,有显著性差异(P<0.05或0.01)。结论脑卒中急性期心肌酶、QTd有显著变化,二者的监测有利于脑卒中病情及心脏受累程度的全面评价,对判断患者的预后有重要意义。

Change and significance of myocardial enzymes and QT dispersion degree on electrocardiogram in acute stage patients with cerebral apoplexy

Objective It is to discuss the change and significance of myocardial enzymes and QT dispersion degree(QTd) in acute stage patients with cerebral apoplexy.Methods 71 patients with cerebral hemorrhage,78 patients with cerebral infarction and 57 healthy old people were chosen.Myocardial enzymes and QTd in the groups were determined respectively.Then the groups were compared.Results Aspartase transferase(AST),lactate dehydrogenase(LDH),creatine phosphokinase(CK) and creatine phosphokinase isoenzyme(CK-MB) and QTd in cerebral hemorrhage group and cerebral infarction group were obviously higher or more prolonged than those in control group and there was significant difference(P<0.05 or 0.01).AST,LDH and CK in cerebral hemorrhage group were significantly higher than those in cerebral infarction group and there was significant difference(P<0.01).There was no significant difference on CK-MB and QTd between cerebral hemorrhage group and cerebral infarction group(P>0.05).Compared with low grade group,all indexes in midrange group and severe group were significantly higher or more prolonged and there was significant difference(P<0.05 or 0.01),except AST in moderate group was higher but there was no significant difference(P>0.05).Compared with midrange group,AST and CK in severe group were significant higher and there was significant difference(P<0.05),but there was no significant difference on LDH,CK-MB and QTd(P>0.05).Compared with no disorder of consciousness group,AST,LDH,CK,CK-MB and QTd were significantly higher or more prolonged in disorder of consciousness group and there was significant difference(P<0.05 or 0.01).Conclusion There are significant changes on myocardial enzymes and QTd in acute stage patients with cerebral apoplexy.Conclusions Monitoring of the two is profited to the complete estimation on illness state of cerebral apoplexy and heart affected degree,which has important significance on judgment of patient's prognosis.