脑心综合征对急性缺血性脑卒中预后评价的临床意义

目的 探讨脑心综合征对急性缺血性脑卒中预后评价的临床意义.方法 对我院2008年1月至2012年12月收治的504例急性缺血性脑卒中患者进行回顾性分析.按照缺血性脑卒中的病灶体积进行分型,将本组504例患者分为腔隙性脑梗死、大灶脑梗死2组,比较这2组脑心综合征的发生率.按照症状体征演进过程进行分型,将本组215例大灶脑梗死患者分为非进展性大灶梗死和进展性大灶梗死2组,比较这2组患者脑心综合征的发生率.根据脑缺血灶的解剖部位将患者分4组：脑干、皮层各叶、基底节区及小脑,比较各组脑心综合征的发生率.结果 缺血性脑卒中类型与脑心综合征发生率具有相关性,大灶脑梗死的脑心综合征发生率（76.74％）高于腔隙性脑梗死（5.54％）,差异有统计学意义（P＜0.01）.进展性大灶脑梗死的脑心综合征的发生率（87.72％）高于非进展性大灶脑梗死（72.78％）,差异有统计学意义（P＜0.05）.缺血病灶位于脑干的脑心综合征发生率（73.53％）高于缺血病灶位于大脑皮层各叶（48.99％）、基底节区（22.22％）及小脑（17.24％）,差异有统计学意义（P＜0.01）.结论 脑心综合征与脑梗死类型和部位相关,脑心综合征提示脑梗死进展或累及脑干.

Relationship between the brain-heart syndrome and the prognosis in patients with acute ischemic stroke

Objective To analyze the significance of brain-heart syndrome on evaluating clinical outcome in patients with acute ischemic stroke.Methods The prognosis of the total of 504 patients with acute ischemic strokein our hospital from January 2008 to December 2012 were analyzed retrospectively.Patients were divided into two groups according to the ischemic volume：lacunar infarction and large artery atherosclerosis occlusion,incidences of the brain-heart syndrome among the two groups were compared.And also,patients were divided into two groups according to the evolution of clinical process：deteriorating infarction or non-deteriorating infarction.Incidences of the brain-heart syndrome between the two groups were compared.Moreover,patients were divided into four groups according to the location of the ischemic brain lesion：brainstem,cortex lobes,basal ganglia and cerebellum.Incidences of the brain-heart syndrome among the groups were compared.Results Incidence of brain-heart syndrome was relevant with the subtype of the ischemic stroke,high incidence was in the large artery atherosclerosis occlusion group （76.74％）rather than in the lacunar infarction group （5.54％）,P ＜ 0.01.A high incidence of brainheart syndrome（87.72％）was seen in the group of patients with deteriorating infarction rather than in the infarction group without deteriorating（72.78％）,P ＜ 0.05.Meanwhile,infarctions located in brainstem may have the highest incidence of brain-heart syndrome among the four subgroups （73.53％ of brainstem,48.99％ of cortex lobes,22.22％ of basal ganglia,and 17.24％ of cerebellum）,P ＜0.01.Conclusion The type and the location of ischemic lesions were relevant with the incidence of brain-heart syndrome.Brain-heart syndrome may predict the ischemic lesion involve brainstem or make a deterioration.