Differences in left ventricular diastolic dysfunction between eccentric and concentric left ventricular hypertrophy in hypertensive patients with preserved systolic function

Left ventricular (LV) hypertrophy (LVH) may be eccentric or concentric (2 × LV posterior wall thickness relative to LV end-diastolic dimension ≤ 0.42 or > 0.42, respectively). The LV diastolic function between age-matched hypertensive patients with eccentric and concentric LVH was compared in the present study. Echocardiography was used to measure LV mass index (LV mass/body surface area; LVMI) as an index of LVH. LV diastolic function was assessed by measurements of peak early transmitral flow velocity (E)/peak late transmitral flow velocity (A) (the E/A ratio), peak early diastolic mitral annular velocity (e') and the E/e' ratio. Although LVMI, E/A and e' did not differ between the two groups, E/e' was significantly higher (worse) in patients with concentric LVH (13.4 ± 5.4) than in those with eccentric LVH (11.1 ± 3.6). Among hypertensive patients with LVH, those with concentric LVH may, therefore, have more severe LV diastolic dysfunction than those with eccentric LVH even if their LVMIs, which reflect the degree of LVH, are similar.     

左室肥厚与左心室舒张功能不全相关性的研究

目的 探讨心脏左室壁肥厚,评价左室舒张功能不全的可行性。方法 对15例非左心室肥厚（对照组：室壁厚度≤11mm）和15例左心室肥厚（LVH组：室壁厚度≥12mm）高血压病人,采用胸骨旁长轴切面测量室间隔（IVSd）及左室后壁厚度（LVPWd）;在心尖四腔切面,常规测量二尖瓣血流频谱E峰、A峰及E／A比值。选取室间隔、左室侧壁的二尖瓣瓣环水平为取样点,使用组织多普勒（DTI）测量心肌舒张早期峰值速度（Ve）、舒张晚期峰值速度（Va）及Ve/Va比值。30例受试者均行冠脉造影,测量左室舒张末压（LVEDP）。结果 与对照组比较,LVH组的IVSd、LVPWd、LVEDP明显增大,P〈0．01;而E／A、Ve／Va明显减小（P〈0．01）。IVSd和LVPWd与LVEDP呈直线正相关（r分别为0．79和0．77,P〈0．001）。IVSd与V e/Va和E／A呈直线负相关（r分别为-0．77和-0．70,P〈0．001）;LVPWd与Ve/Va和E／A亦呈直线负相关（r分别为-0．66和-0．56,P〈0．001）。结论 左室肥厚可以作为评价左室舒张功能的简便、可靠指标。     

高血压左室肥厚及舒张功能不全与血浆B型脑钠肽关系

目的:探讨原发性高血压患者血浆B型脑钠肽与左室肥厚及舒张功能不全的关系。方法:原发性高血压患者87例,分单纯高血压不伴左室肥厚组40例,高血压伴左室肥厚组47例,其中高血压伴左室肥厚组无舒张功能不全21例,伴舒张功能不全26例。另有33例健康者为对照组。采用放射免疫法测定B型脑钠肽。结果:高血压伴左室肥厚组血浆B型脑钠肽显著高于高血压不伴左室肥厚组(P<0.05),同时伴舒张功能不全组患者血浆B型脑钠肽显著高于无舒张功能不全组患者(P<0.05),高血压不伴左室肥厚组患者血浆B型脑钠肽与对照组相似(P>0.05)。结论:高血压左室肥厚合并左室舒张功能不全患者血浆B型脑钠肽升高,B型脑钠肽检测有助于临床早期诊断左室舒张功能不全。     

On the connection between left ventricular hypertrophy and diastolic dysfunction in arterial hypertension

AIM: To evaluate relationships between arterial pressure (AP), myocardial mass of the left ventricle (LVMM) and left ventricular diastolic function (LVDF) in patients with hypertension stage I and II. MATERIAL AND METHODS: 89 hypertensive patients and 30 healthy subjects (control group). RESULTS: Initial defects in LVDF in the absence of its hypertrophy were detected already in hypertension stage I. At hypertension stage II diastolic dysfunction occurs in marked left ventricular hypertrophy. A close correlation exists between LVMM and LVMM index, on the one hand, and parameters of diastolic dysfunction, on the other hand. CONCLUSION: There is a close correlation between left ventricular hypertrophy and its diastolic dysfunction.     

心肌肥厚性疾病患者左心室扭转与心肌纤维化的相关性研究

目的应用三维超声斑点追踪成像技术分析心肌肥厚性疾病患者左心室扭转与心肌纤维化程度的相关性。 方法收集2017年7月至2019年2月在哈尔滨医科大学附属第四医院行心脏超声及心脏磁共振（CMR）检查的心肌肥厚性疾病患者31例,根据CMR钆造影剂延迟强化阳性与否诊断患者是否存在心肌纤维化,并将患者分为心肌纤维化组20例,无心肌纤维化组11例。另选取健康体检者35例作为对照组。应用三维斑点追踪成像技术测量左心室基底段、中间段、心尖段旋转角度峰值,左心室整体扭力及左心室扭转角度峰值。比较心肌肥厚性疾病患者与健康对照组的常规二维超声参数,以及心肌肥厚性疾病心肌纤维化组、无心肌纤维化组与健康对照组的左心室旋转、扭转参数。分析左心室扭转角度峰值与钆造影剂延迟强化阳性心肌/左心室心肌质量比值的相关性。 结果与健康对照组比较,心肌肥厚性疾病无心肌纤维化组及心肌纤维化组的左心室基底段、中间段、心尖段旋转角度峰值及左心室扭转角度峰值均明显升高（无心肌纤维化组：t=4.45、7.51、-5.45、-6.79,心肌纤维化组：t=-5.53、-9.84、-5.82、-9.45;P均<0.01）;心肌肥厚性疾病心肌纤维化组左心室心尖段旋转角度峰值及左心室扭转角度峰值较无心肌纤维化组明显升高（t=-2.71、2.36,P均<0.05）。心肌肥厚性疾病患者左心室扭转角度峰值与钆造影剂延迟强化阳性心肌/左心室心肌质量比值呈正相关（r=0.58,P=0.001）。 结论三维斑点追踪技术可有效评估心肌肥厚性疾病患者左心室扭转及旋转,左心室整体扭转角度峰值与左心室心肌纤维化呈正相关,三维斑点追踪技术可为临床检测心肌肥厚患者心肌纤维化提供新的方法和选择。     

Preventing sudden cardiac death in post myocardial infarction patients with left ventricular dysfunction

Cardiovascular nurses play a key role in caring for the post myocardial infarction (MI) patient. That role includes reducing the risk of MI recurrence and the progression to heart failure. Equally important is evaluating for the risk of sudden cardiac death (SCD). Although drugs such as beta blockers and angiotensin converting enzyme (ACE) inhibitors are typically indicated to help reduce the risk of SCD, data continue to show that using implantable cardioverter defibrillators (ICDs) saves lives compared with using medications alone. This article focuses on the problem of SCD, the findings of recent clinical trials, the implant criteria for defibrillators, new Centers for Medicare & Medicaid Services (CMS) decisions regarding reimbursement, and postoperative care for the defibrillator patient. Included are 2 case studies demonstrating the nurses' role in identifying asymptomatic patients who are indicated for ICD therapy. It is critical that cardiovascular nurses be aware of the latest scientific evidence showing improved outcomes for post-MI patients, particularly those with left ventricular dysfunction.     

高血压患者脉压与左心室肥厚的关系

目的 探讨高血压患者脉压与左心室肥厚的关系。方法 将高血压患者按脉压差高低分为4组：≤60mmHg、61～80mmHg、81～100mmHg和〉100mmHg。超声心动图检查，测量舒张末期室间隔厚度（IVSd）、舒张末期左心室内径（LVIDd）、舒张末期左心室后壁厚度（LPWd），求出左心室重量指数（LVMI），并分别进行比较。结果①高血压患者脉压与其年龄具有密切的关联。年龄增高，脉压增大；与血脂、血糖无明显的关系。②随着脉压差增大，舒张末期室间隔厚度、舒张末期左心室内径、舒张末期左心室后壁厚度逐渐增大。4组间比较差异具有显著性。结论 高血压患者脉压增大是导致左心宣肥厚的重要因素。     

Perceptual differences between stroke patients with cerebral infarction and intracerebral hemorrhage

OBJECTIVE: To assess perceptual performances of patients with intracerebral hemorrhage (ICH) compared with those of ischemic patients early after stroke and to analyze the psychometric properties of three perceptual tests used in the study. DESIGN: Cross-sectional study. SETTING: A rehabilitation unit at a teaching hospital. PATIENTS: Twenty-two stroke patients with ICH and 22 demographically matched stroke patients with infarction. MAIN OUTCOME MEASURES: Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Rivermead Perceptual Assessment Battery (RPAB), and Motor-Free Visual Perception Test (MVPT). RESULTS: Stroke patients with ICH had significantly more severe deficits on a task of thinking operations than did patients with infarction. A significant lateralized effect of stroke existed in the ICH group, with patients with right-hemisphere strokes scoring lower than patients with left-hemisphere strokes on the figure-ground discrimination subtest of the RPAB. A considerable overlap among the three instruments was found. Yet, the observed correlations between supposedly similar subtests from the tests proved to be moderate, indicating that to a certain extent these test measures tap different perceptual processes. Four factors were generated from a joint LOTCA-RPAB-MVPT factor analysis. They assessed different facets of perceptual functioning, including higher-level and lower-level perceptual skills, part/whole conceptual integration, and color perception. This factor pattern accounted for 75.5% of the variance. CONCLUSIONS: Higher-level perceptual functions tend to be relatively susceptible to ICH stroke pathology early in the course of the disease. This information has important clinical implications in the early treatment planning for the stroke patients with ICH, such that specific compensatory strategies for these deficiencies should be devised to facilitate a successful rehabilitation. Knowledge regarding the influences of specific deficits on the performance of daily activities may also be useful to the patients' family.     

基于心腔内超声造影测量左心室肥厚患者室壁厚度

目的 采用左心室腔内超声造影(LVO)改善心内膜显影,评价LVO诊断左心室心肌肥厚的价值。方法 选择经常规超声心动图检查不能清晰显示并测量左心室壁厚度的患者66例,测量造影前后室间隔、左心室侧壁基底段、中间段及心尖段的室壁厚度,并用Bland-Altman法分析观察者内和观察者间的一致性。结果 LVO后,65例(98.48%,65/66)心内膜边缘的清晰程度明显改善,易于测量室壁厚度。LVO测定的室壁厚度与常规超声心动图所测厚度的差异有统计学意义(P<0.05)。常规超声与LVO测量的室壁厚度相符仅31个节段。Bland-Altman法分析显示,左心室壁厚度测LVO值的观察者内和观察者间的一致性较好。结论 LVO能够通过增进左心室腔的显影,改善心内膜边缘的清晰度,有利于准确测定心肌厚度。     

Late ventricular potentials in left ventricular hypertrophy in patients with stage-II hypertension

AIM: To evaluate diagnostic significance of high-resolution ECG in patients with blood hypertension (BH) stage II with left ventricular hypertrophy (LVH) in the presence or absence of angiographically verified atherosclerosis of the coronary arteries. MATERIALS AND METHODS: ECG (registration of late ventricular potentials by M. Simson and R. Haberl), echo-CG and coronaroventriculography were performed in 63 males with BH stage II. RESULTS: Late ventricular potentials (LVP) were detected according to M. Simson in 6.3% of the examinees, while according to R. Haberl in none of them. Duration of filtered complex QRS was normal in all the patients. LVP characteristics were not significantly different in the presence or absence of coronary atherosclerosis. Severe and moderate LVH patients differed significantly by duration of low-amplitude high-frequency signals. An inverse correlation existed between duration of low-amplitude signals in the end of filtered complex QRS and parameters of echo-CG. CONCLUSION: LVP registration both by M. Simson and R. Haberl failed to provide additional information on substrate of the arrhythmia in hypertension stage II patients with LVH free of clinical symptoms of tachyarrhythmia. However, there is an inverse correlation between duration of low-amplitude signals in the end of filtered complex QRS and thickness of interventricular septum, asymmetry index, left ventricular myocardial mass.     

脑梗死患者急性期嗅觉障碍与认知障碍关系的探讨

目的：分析脑梗死患者急性期嗅觉功能与认知功能的关系,探讨临床简易嗅觉定量测试法在脑梗死患者认知障碍筛查中的应用价值。方法选取2010年10月到2011年1月我院神经内科住院诊断为脑梗死且入院后病情无继续加重,具备嗅觉查体结果及神经心理学测试结果的患者41例为病例组,同期在岗的医护人员、在读的硕士或博士研究生及进修医生、住院患者的健康家属中自愿接受嗅觉及神经心理学测试的41例为对照组。全部入组者均具备标准的蒙特利尔认知评估量表（ MoCA ）检测结果;均接受临床嗅觉查体。查体采用参照临床神经病学检查法及标准的嗅觉心理物理测试法而自行设计的简易嗅觉定量测试法。所得数据应用SPSS 17.0程序软件包进行统计学分析。结果（1）符合入组标准者82例,病例组41例,男14例,女27例;对照组41例,男12例,女29例,两组的性别分布差异无统计学意义（ P＞0.05）。平均年龄病例组（58.20±9.29）岁,对照组（53.46±8.82）岁,两组年龄差异有统计学意义（ P＜0.05）。将两组年龄分别划分为40～49岁、50～59岁、60～69岁、70～79岁后,两组的年龄段分布情况比较差异无统计学意义（ P＞0.05）。（2）病例组全部头MRI结果均报告为腔隙性脑梗死,病灶单发或多发,部分伴有陈旧性病灶。（3）六种不同的气味下病例组及对照组左右侧鼻孔嗅觉功能比较无差异（ P＞0.05）。（4）两组MoCA得分有差异（ P＜0.05）,对照组 MoCA 分值高于研究组。（5）病例组嗅觉识别阈值与 MoCA 得分存在负相关（ r＝-0.350,P＜0.05）,即嗅觉识别阈值越高者MoCA得分越低;对照组嗅觉识别阈值与MoCA得分无相关性（P＞0.05）。（6）病例组MoCA值与年龄无相关（P＞0.05）;对照组MoCA值与年龄呈负相关（r＝-0.342,P＜0.05）,即随着年龄的增长MoCA值降低;将全部入组者合并观察其MoCA值与年龄存在负相关（ r＝-0.309, P＜0.05）。（7）两组嗅觉识别阈与年龄呈正相关性（病例组r＝0.563,P＜0.05;对照组r＝0.541,P＜0.05）,即随年龄的增加嗅阈增高;将全部入组者合并观察,其嗅觉识别阈与年龄亦存在正相关（ r ＝0.578, P＜0.05）。结论脑梗死患者即使头MRI仅显示腔隙性梗死其认知功能较正常人亦差。无论是脑梗死患者还是正常人,随着认知功能的减退嗅觉功能减退;随着年龄的增长,嗅觉功能及认知功能均有所下降。我们的简易嗅觉定量测试法具有有效性和可行性。     

原发性高血压患者血清总胆红素水平与左心室肥厚的相关性研究

目的分析初诊或未治疗的原发性高血压患者血清总胆红素水平与左心室肥厚的关系。方法选取2015年1至8月在鹤山市人民医院就诊资料完整的新发原发性高血压患者200例,根据左心室质量指数分为左心室肥厚组(58例)及左心室正常组(142例)。比较两组患者的一般临床资料、生化指标和超声心动图参数,并采用单因素和多因素回归分析左心室肥厚的相关因素。结果在原发性高血压患者中,左心室肥厚组血清总胆红素水平明显低于左心室正常组[(22.47±6.75)U/L vs.(33.24±5.84)U/L],单因素分析结果表明,收缩压(OR=1.569,95%CI 1.125~2.896;P=0.002)和年龄(OR=1.372,95%CI 1.103~1.925;P=0.047)是左心室肥厚的危险因素,而血清总胆红素(OR=0.586,95%CI 0.259~0.852;P=0.001)是左心室肥厚的保护因素,进一步多因素Logistic回归分析表明,血清总胆红素(OR=0.459,95%CI 0.231~0759;P=0.018)仍是左心室肥厚的保护因素。结论原发性高血压患者血清总胆红素是左心室肥厚的保护因素,监测血清总胆红素变化可能对早期发现左心室重构有一定意义。     

脉压与冠心病患者左室肥厚的关系探讨

目的 探讨冠心病患者左室肥厚与脉压的关系.方法 将本院收治的96例冠心病患者根据脉压大小分为3组:A组30例,脉压≤45 mmHg;B组35例,55 mmHg≥脉压＞45 mmHg;C组31例,脉压＞55 mmHg.采用彩色超声心脏诊断仪测定舒张期室间隔厚度(IVST)、左室后壁厚度(PWT)、左室舒张末期内径(LVD...     

Serum cardiac troponin T in patients hospitalized with heart failure is associated with left ventricular hypertrophy and systolic dysfunction

BACKGROUND: Cardiac troponin T (cTnT) is a highly sensitive and specific marker of acute myocardial infarction. Serum cTnT is also slightly elevated in patients with severe heart failure and is associated with left ventricular hypertrophy (LVH) in patients treated with haemodialysis. In this study serum cTnT concentrations and echocardiographic findings were investigated in heart failure patients without acute coronary syndrome. cTnT was also compared with other cardiac markers and plasma levels of brain natriuretic peptide (BNP). METHODS: Twenty-six patients hospitalized with heart failure were included in the study. Echocardiographic measurements and blood sampling were carried out 12-36 h after admission. Serum cTnT (3rd generation assay), cardiac troponin I (cTnI), creatine kinase MB (CKMB) and CK were measured. Plasma BNP was analysed using the Shionoria assay. LVH was defined as left ventricular mass index (LVMI) > 125 g/m for males and > 110 g/m for females. Left ventricular systolic function was estimated from the mitral annulus motion (AV-mean LV). RESULTS: Median cTnT was 0.012 (< 0.010-0.032) microg/L. Sixty-two percent of the patients (16 of 26) had elevated serum cTnT >or= 0.010 micro/L. cTnT was positively correlated with CKMB (rho = 0.40, p = 0.04) and BNP (rho = 0.43, p = 0.03), but not with cTnI and CK. A negative correlation was found between cTnT and AV-mean LV (rho = -0.58, p = 0.007), and there was a positive correlation between cTnT and LVMI (rho = 0.44, p = 0.03). No other analyte was correlated to LVMI. CONCLUSIONS: Serum cTnT but not cTnI was associated with left ventricular dysfunction and LVH in patients hospitalized with heart failure. This explains why cTnT tends to be slightly elevated in patients with heart failure without symptoms of acute myocardial ischaemia.     

腹膜透析患者左心室肥厚与腹膜转运特性的关系

目的 探讨腹膜透析患者左心室肥厚与腹膜转运特性的关系.方法 69例持续性不卧床腹膜透析（CAPD）患者,超声心动图检查测算左心室心肌质量指数（LVMI）,应用改良腹膜平衡试验（PET）,按患者腹膜转运类型分高转运组、高平均转运组、低平均转运组及低转运组,同时检测血红蛋白、血白蛋白、尿素氮、肌酐等,以及测定尿素清除指数（Kt/V）和肌酐清除率（Ccr）,记录透析龄、收缩压、舒张压.结果 腹膜高转运和高平均转运例数比低转运和低平均转运多（41/28）;高转运组、高平均转运组、低平均转运组、低转运组透析龄分别为（39.2±21.8）、（26.6±15.6）、（28.6±14.4）、（45.7±35.0）岁,4组间差异有统计学意义（F=4.128,P＜0.05）,高转运组透析龄比高平均转运组、低平均转运组长（P均＜0.05）,低转运组透析龄比高平均转运组、低平均转运组长（P均＜0.05）;LVMI与4h透析液肌酐与血肌酐比值（D/Pcr）、收缩压、舒张压呈正相关（r值分别为0.339、0.351、0.316,P均＜0.01）,与白蛋白呈负相关（r=-0.292,P＜0.05）;69例CAPD患者发生左心室肥厚44例,发生率63.8％,高转运组高于低平均转运组及低转运组（x2值分别为5.455、5.091,P均＜0.05）.结论 维持性腹膜透析患者高转运特性占大多数,有较高左心室肥厚发生率,高转运者更为明显.D/Pcr、收缩压、舒张压升高和低白蛋白与左心室肥厚密切相关.     

维持性血液透析患者左心室肥厚与血清脂联素水平的关系

目的 探讨尿毒症血液透析患者左心室肥厚与血清脂联素（adiponectin,ADPN）水平的关系.方法 选择北京市平谷区医院肾内科32例维持性血液透析（MHD）患者,分成左心室肥厚组（A组）和左心室厚度正常组（B组）,彩色多普勒超声测定左心室心肌重量（LvM）及计算左心室心肌重量指数（LVMI）;采用酶联免疫法测定血清ADPN水平.比较两组患者LVMI和血清ADPN的关系;并与18例健康体检者进行比较.同时分析左心室肥厚与高血压的关系.结果 MHD组血清ADPN水平显著明显高于正常对照组;A组患者血清ADPN水平低于B组（P＜0.05）;相关分析发现,ADPN与LVM、LVMI呈显著负相关（r=-0.576,P＜0.001）.结论 血清ADPN水平可能与MHD患者左心室肥厚的发生和发展过程存在相关性,与尿毒症心血管疾病关系密切.     

Serum cardiac troponin T in patients hospitalized with heart failure is associated with left ventricular hypertrophy and systolic dysfunction

Background: Cardiac troponin T (cTnT) is a highly sensitive and specific marker of acute myocardial infarction. Serum cTnT is also slightly elevated in patients with severe heart failure and is associated with left ventricular hypertrophy (LVH) in patients treated with haemodialysis. In this study serum cTnT concentrations and echocardiographic findings were investigated in heart failure patients without acute coronary syndrome. cTnT was also compared with other cardiac markers and plasma levels of brain natriuretic peptide (BNP). Methods: Twenty-six patients hospitalized with heart failure were included in the study. Echocardiographic measurements and blood sampling were carried out 12-36?h after admission. Serum cTnT (3rd generation assay), cardiac troponin I (cTnI), creatine kinase MB (CKMB) and CK were measured. Plasma BNP was analysed using the Shionoria assay. LVH was defined as left ventricular mass index (LVMI)&;gt;125?g/m&;lt;formula&;gt;²&;lt;/formula&;gt; for males and&;gt;110?g/m&;lt;formula&;gt;²&;lt;/formula&;gt; for females. Left ventricular systolic function was estimated from the mitral annulus motion (AV-mean LV). Results: Median cTnT was 0.012 (&;lt;0.010-0.032)?μg/L. Sixty-two percent of the patients (16 of 26) had elevated serum cTnT≥0.010?μg/L. cTnT was positively correlated with CKMB (ρ=0.40, p=0.04) and BNP (ρ=0.43, p=0.03), but not with cTnI and CK. A negative correlation was found between cTnT and AV-mean LV (ρ=?0.58, p=0.007), and there was a positive correlation between cTnT and LVMI (ρ=0.44, p=0.03). No other analyte was correlated to LVMI. Conclusions: Serum cTnT but not cTnI was associated with left ventricular dysfunction and LVH in patients hospitalized with heart failure. This explains why cTnT tends to be slightly elevated in patients with heart failure without symptoms of acute myocardial ischaemia.     

Effect of indecainide in patients with left ventricular dysfunction

Indecainide, a new antiarrhythmic agent classified as type Ic was evaluated in 11 patients with heart disease who had greater than or equal to 30 ventricular premature complexes/hour, moderate-to-marked left ventricular dysfunction, and mean ejection fraction 34% +/- 8%. Patients received indecainide, 50 mg by mouth, every 6 hours and the dose was increased until greater than or equal to 80% suppression was noted, adverse effects occurred, or a maximum dose of 100 mg indecainide was given every 6 hours. Ventricular premature complexes were suppressed greater than or equal to 80% in nine patients (p less than 0.05) and ventricular tachycardia episodes were completely suppressed in five of eight patients. The effective or maximal mean daily indecainide dose was 191 +/- 32 mg; half of the responders achieved achieved efficacy at serum drug concentration greater than or equal to 600 ng/ml. Serum drug concentration was directly related to gender (r = 0.78, p less than 0.04) and inversely related to creatinine clearance (r = 0.74, p less than 0.05) and ejection fraction (r = 0.71, p less than 0.02). Indecainide prolonged mean PR and QRS intervals (p less than 0.05) but not QT or QTc. There was a linear relation between percent change in PR (r = 0.80, p less than 0.001) and QRS (r = 0.66, p less than 0.001) intervals and serum drug concentration. After starting or increasing the dose, careful observation of patients with decreased renal function or reduced ejection fraction should be exercised because they attain higher drug concentration than normal subjects.     

脑梗死、脑出血病人的心电图表现

1对象与方法根据我院1998年7月～2008年3月住院患者的心电图总结,按中华医学会脑血管病会议通过诊断标准,经头颅CT扫描确诊脑出血、脑梗死的首次发病患者166例,均在发病后2h～2d内入院。所有患者无明显精神障碍、肝肾改变、电解质变化等,既往无心脏病史及可引起心电图异常的疾患曾查心电图正常者。