急性脑梗死后心电图异常及其相关危险因素分析

目的 探讨急性脑梗死患者不同病损部位的心电图异常及心电图异常时血糖、C-反应蛋白、血浆白蛋白、电解质、血红蛋白、低密度脂蛋白的特点及其与高血压病、糖尿病、冠心病、年龄的关系。方法 分析2015年1月～2016年1月入住本院的201例急性脑梗死患者的心电图、血糖、血浆白蛋白、C-反应蛋白、电解质、血红蛋白、低密度脂蛋白的变化。入选标准:发病72 h内入院; 颅脑CT或MRI明确梗死部位; 查入院当天十二导联心电图和入院后首次空腹血血糖、血浆白蛋白、C-反应蛋白、电解质、血红蛋白、低密度脂蛋白水平; 仔细询问既往病史,记录有无高血压病、糖尿病、心脏病病史(包括各种心律失常、心肌缺血、冠心病等)。结果 急性脑梗死患者心电图异常的发生率为74.63%,心电图异常主要为ST-T改变; 大面积脑梗死患者心电图异常发生率最高(100%),其次为脑干梗死(80%)。心电图异常组患者年龄、C-反应蛋白水平与心电图正常组比较有显著差异(P<0.05),心电图异常组患者血糖、血浆白蛋白、血红蛋白、低密度脂蛋白水平较心电图正常组无显著差异(P>0.05)。结论 脑梗死可以通过神经、体液等多种途径导致心电图异常,不同部位脑梗死出现心电图异常存在差异性,高龄及伴C-反应蛋白升高患者更容易发生心电图异常。高血压病、糖尿病、冠心病、糖尿病为急性脑梗死后心电图异常的危险因素。

Analysis arrhythmia of abnormal electrocardiogram and relative risk factors in patients with cerebral infarction

ObjectiveTo analyse the changes of electrocardiogram in patients with acute cerebral infarction,study the characterristic of the changes in blood glucose,plasma albumin,eletrolytes,C-reactive protein,hemoglobin,low density lipoprotein, discuss the relationship between abnormal electrocardiogram and age,hypertension,diabete,coronary heart disease.To provide some data for clinical work.Methods Analysis the clinical data of the changes in blood glucose,plasma albumin,eletrolytes,C-reactive protein,hemoglobin,low density lipoprotein in patients in hospital with cerebral infarction.Standard:less than 72 hours after outbreak; definite diagnosis by CT or MRI,clear diseased region; examine ECG on first day in hospital,examine blooodglucose,plasma albumin,eletrolytes,C-reactive protein,hemoglobin,low density lipoprotein of the first fasting plasma; inquiry past history and record such as hypertension,diabete,coronary heart disease history.Results The incident rate of abnormal ECG in cerebral infarction patients is 74.63%,all the massive brain infarction patients happend abnormal ECG and 80% of brainstem infarction patients happend abnormal ECG.The ageing and c-reactive protein of patients has distinctive difference to the normal group.The blood glucose,plasma albumin,hemoglobin,low density lipoprotein in abnormal ECG group has no distinctive difference to the normal group.Conclusion Cerebral infarction will cause ECG change through nerves and body fluid.Cerebral infarction in different part may cause different abnormal ECG,meanwhile,the patients with high C-reactive protein and ageing tend to presents abnormal ECG.