急性期脑梗死患者不同临床特征对心肌的影响

目的:根据心电图、心肌酶谱及超声心动图检查结果,观察脑梗死患者急性期、恢复期心脏功能及心肌电生理的变化,探讨不同部位、不同病情程度的脑梗死患者心肌损害的特点和发病机制。方法:选择79例脑梗死患者作为研究对象,分别在急性期进行心电图、心肌酶谱、超声心动图检查,恢复期复查心电图、心肌酶谱。56例同期健康志愿者作为正常对照组,进行一次心电图、心肌酶谱及超声心动图检查。结果:脑梗死组急性期心电图的异常率为40.5%,岛叶组的心电图异常率为60.7%,明显高于非岛叶组的29.4%(P<0.01);中型组的心电图异常率为68.2%,重型组的心电图异常率为78.6%,两者均明显高于轻型组的14.0%(P<0.01)。脑梗死组急性期CK、CK-MB、LDH和cTnI均明显高于对照组(P<0.05),岛叶组的CK、CK-MB、LDH和cTnI均高于非岛叶组(P<0.05);中型组CK-MB、cTnI和Mb均高于轻型组(P<0.05);重型组心肌酶均高于轻型组(P<0.05),重型组CK、CK-MB、LDH和Mb均高于中型组(P<0.05)。急性期脑梗死组左房内径、A峰均高于对照组(P<0.01),E峰、EF、FS均低于对照组(P<0.05),急性期脑梗死组二尖瓣返流率和主动脉瓣返流率均高于对照组(P<0.05)。结论:脑梗死患者急性期心电图检查的异常率和心肌酶的增高与梗死部位和病情程度有关,急性期脑梗死组左房增大,伴有不同程度的左室功能障碍,且发生二尖瓣返流和主动脉瓣返流的频率相对较高。

Patients with cerebral infarction of different clinical characteristics impact myocardial in acute stage

Objective：Application of ECG,myocardial enzymes and echocardiography were observed in patients with acute and recovery cerebral infarction,cardiac function and myocardial electrophysiological changes.Explore the characteristics and the pathogenesis of myocardial damage in cerebral infarction patients with different parts and different degree.Methods：79 cerebral infarction patients were conducted in the acute stage of ECG,myocardial enzymes,echocardiography,convalescence review ECG,myocardial enzymes.56 the control groups were healthy volunteers who conducted of ECG,myocardial enzymes and echocardiography in the same period.Results：The rate of abnormal ECG is 40.5% in the infarcts group.There is a higher rate of abnormal ECG in the insular infarcts group than in the non-insular infarcts group（60.7%vs.29.4%,P〈0.01）.There is more abnormal ECG in the moderate and severe type patients with cerebral infarction than in the mild group（68.2%,78.6%vs.14.0%,P〈0.01）..No notable difference can be detected between moderate and severe type groups.To compare with the control group,CK,CK-MB,LDH and cTnI of patients with cerebral infarction in acute stage are significantly higher（P〈0.05）.The result of the CK,CK-MB,LDH and cTnI in patients of insular infarcts group are higher than those of non-insular infarcts group（P〈0.05）.The results of the CK-MB,cTnI and Mb in patients of moderate type group are higher than those of the mild type group（P〈0.05）.The severe type group is higher than the mild type group in myocardial enzymes results at acute stage（P〈0.05）.The severe type group of CK,CK-MB,LDH and Mb are higher than moderate type group（P〈0.05）.The result of left atrium diameter and atrial wave of mitral flow value in patients with cerebral infarction at acute stage is higher than that of the control group（P〈0.01）.The result of early wave of mitral flow value,EF and FS in patients with cerebral infarction at acute stage are lower than the control group（P〈0.05）.The rate of mit