急性脑卒中患者的心电图变化

目的：探讨急性脑卒中患者心电图变化的临床意义。方法：对经颅脑CT及临床表现确诊的126例脑卒中（缺血性脑卒中40例,出血性脑卒中86例）患者的临床资料进行回顾性分析。分析急性脑卒中患者心电图变化（ST-T变化、Q-T间期改变及心律失常等）、心肌酶谱的变化。结果：126例急性脑卒中患者中109例（86.5%）发生心电图异常。脑出血组发生心电图异常患者比例显著高于缺血性脑卒中组（90.7%比77.5%,P〈0.05）。靠近基底节及丘脑的病变,其心电图发生异常的几率较高,分别为96.4%、92.3%。急性脑卒中患者的心电图异常与出血量有关,出血量大者（〉40ml,20～40ml）心电图异常率（96.2%,92.3%）明显高于出血量小者（〈20ml,81.0%）,P〈0.05。结论：急性脑卒中多有心电图及心肌酶谱的改变,在治疗脑部病变的同时,应加强心脏检测,一旦出现心脏损害,及时调整治疗方案,以改善脑卒中患者的预后。

Changes of electrocardiogram in patients with acute stroke

Objective: To investigate changes of electrocardiogram(ECG) in patients with acute stroke.Methods: Clinical data of 126 acute stroke patients(40 cases with ischemic stroke and 86 cases with hemorrhagic stroke),who were diagnosed by transcranial CT and clinical symptoms,were retrospectively analyzed.Changes of ECG(ST-T,QT interval change and arrhythmias) and myocardial enzymes in patients with acute stroke were analyzed.Results:In 126 patients with acute stroke,there were abnormal ECG occurred in 109 patients(86.5%).Ratio of patients with abnormal ECG in hemorrhagic stroke group was significantly higher than that of ischemic stroke group(90.7% vs.77.5%,P<0.05).When stroke occurred near basal ganglia and thalamus,incidence rate of abnormal ECG was high and they were 96.4% and 92.3% respectively.Abnormal ECG rate was related with amount of bleeding in patients with acute stroke,abnormal ECG rates(96.2%,92.3%) of those with large amount of bleeding(>40ml,20～40ml) were significantly higher than that of those with small amount of bleeding(<20ml,81.0%),P<0.05 all.Conclusion:Changes of electrocardiogram are usually found in patients with acute stroke.Monitor of heart should be enhanced while treating cerebral diseases.Once myocardial damage occurs,therapy should be adjusted in time in order to improve prognosis of stroke patients.