重症脑梗死患者急性期心肌标志物和心电图的改变与预后的关系

目的：探讨重症脑梗死患者急性期心肌标志物及心电图的变化,以及对不良预后的预测作用。方法：分别检测60例重症脑梗死患者及58例对照组的心肌标志物和心电图,并随访重症脑梗死患者三个月的全因死亡情况。结果：重症脑梗死组中肌钙蛋白I（cTnI）、肌酸激酶同工酶（CKMB）和肌红蛋白（MYO）升高的比例分别为53.3%、36.7%和76.7%,心电图异常的比例为88.3%,对照组中cTnI、CKMB和MYO升高的比例分别为17.2%、12.1%和22.4%,心电图异常的比例为20.7%,两组相比,重症脑梗死患者中出现心肌标志物增高及心电图异常的比例明显高于对照组（P〈0.05）,重症脑梗死组中cTnI的增高与死亡有关。结论：重症脑梗死患者急性期合并有心肌损伤,cTnI的增高预示了不良预后。

Changes of the Cardiac Marker Concentration and the Electrocardiograms in Severe Acute Ischemic Stroke Patients

Objective：To investigate elevated cardiac markers and electrocardiographic changes in severe acute ischemic stroke patients.Markers of the myocardial injury on admission are also deserved investigation as potential predictors of poor outcome from stroke.Method：We detected the values of cardiac markers and took the electrocardiograms in 60 consecutive patients with severe acute ischemic stroke and 58 controls.We also analyzed the association of baseline levels of cardiac marker with all-cause mortality over a three month follow up.Result：The percentage of the elevated concentrations of cTnI、CKMB and MYO and abnormal electrocardiograms in severe stroke patients was 53.3%、36.7%、76.7% and 88.3%.The ratio in the severe cases are higher than those in the control ones.The mortality of the patients who have higher value of the cardiac marker was higher.Conclusion：Severe acute ischemic stroke patients have the myocardial damage.cTnI positivity is an prognostic predictor in severe acute ischemic stroke.