老年急性脑梗死患者心电图和心肌标志物变化与预后的关系

目的：探讨老年急性脑梗死患者心电图及心肌标志物的变化，及其与预后的关系。方法：回顾性分析2007年5月-2012年5月在我院住院的356例老年急性脑梗死患者（急性脑梗死组）及258例非脑梗死患者（正常对照组）的资料，分析两组患者心电图和心肌标志物变化情况，并对脑梗死患者进行6个月的随访。结果：与正常对照组比较，急性脑梗死组心电图异常的比例明显增大（22.9％比73.3％，χ^2＝150.53，P＝0.00），肌钙蛋白 I [cT-nI，（0.02±0.003）μg/L比（0.07±0.002）μg/L]、肌酸激酶同工酶[（9.1±5.6）U/L比（24.2±4.1）U/L]和肌酸激酶[（98±9.8）U/L比（202.7±10.2）U/L]水平明显升高（P均＜0.05）；老年急性脑梗死患者年纪越大心电图异常率越高[60～75岁（37％），＞75岁（83.8％），χ^2＝80.54，P＝0.00]；随访6个月后，cTnI异常组患者死亡率明显高于cTnI正常组（86.8％比19.5％，χ^2＝95.09，P＝0.00）。结论：老年急性脑梗死时心电图、心肌标志物异常发生率较高，对判断病情、评估预后和指导治疗均有重要意义。

Changes of electrocardiogram and cardiac markers and its relationship with prognosis in aged patients with acute cerebral infraction

Objective：To explore changes of electrocardiogram （ECG）and cardiac markers,and its relationship with prognosis in aged patients with acute cerebral infarction.Methods：The data of 356 aged patients with acute cerebral infarction （acute cerebral infarction group）,who hospitalized in our hospital from May 2007 to May 2012,and 258＆amp;nbsp;non-cerebral infarction patients （normal control group）were retrospectively analyzed.Changes of ECG and cardiac markers were compared between two groups,and patients with cerebral infarction received a six-month follow-up. Results：Compared with normal control group,there were significant rise in percentage of abnormal ECG （22.9%vs.73.3%,χ^2=150.53,P=0.00）,levels of cardiac troponin I [cTnI,（0.02±0.003）μg/L vs.（0.07±0.002）μg/L],creatinine kinase isoenzyme [（9.1±5.6）U/L vs.（24.2±4.1）U/L]and creatinine kinase [（98±9.8）U/L vs.（202.7±10.2）U/L]in acute cerebral infarction group,P〈0.05 all;the older these patients were,the high-er abnormal ECG rate was （60~75 years vs.〉75 years：37.0% vs.83.8%,χ^2=80.54,P=0.00）;After six-month follow up,compared with normal group,there was significant increase in mortality rate （19.5% vs.86.8%,χ2=95.09,P=0.00）in acute cerebral infarction group.Conclusion：Incidence rate of abnormal ECG and cardiac marker level are higher in aged patients with acute cerebral infarction.It possesses important significance for judging patient′s condition,guiding treatment and evaluating prognosis.