心电图缺血性ST-T变化对老年急性脑梗死病情严重程度及预后的评估价值

目的:探讨心电图缺血性ST-T变化对老年急性脑梗死(ACI)患者病情严重程度以及预后的评估价值。方法:选择本院收治的161例老年ACI患者,根据病情严重程度,患者被分为轻度组(62例)、中度组(53例)和重度组(46例);根据随访30d内的生存情况,患者被分为生存组(130例)和死亡组(31例);根据梗死面积,患者被分为腔隙性梗死组(65例)、小面积梗死组(52例)和大面积梗死组(44例)。患者均进行心电图检测,分析不同病情程度、预后、梗死面积与缺血性ST-T变化的关系,以及患者死亡的危险因素。结果:轻度组无ST-T改变比例(51.61%比28.30%,13.04%)显著高于中、重度组;重度组持续性缺血性ST-T改变比例(60.87%比20.97%,15.09%)显著高于轻、中度组,P<0.05或<0.01。死亡组持续性缺血性ST-T改变比例(67.74%比21.54%)显著高于生存组,P=0.001。腔隙性梗死组的无ST-T改变比例(50.77%比26.92%,13.64%)显著高于小、大面积梗死组;大面积梗死组持续性ST-T改变比例(61.36%比24.62%,11.54%)显著高于腔隙性梗死组和小面积梗死组,P均<0.01。多因素Logistic回归分析显示年龄>70岁、病情严重程度、梗死面积和心电图缺血性ST-T改变是ACI患者死亡的独立危险因素(OR=2.165~7.862,P<0.05或<0.01)。结论:ACI患者心电图缺血性ST-T改变与患者预后、病情严重程度有关,可作为临床治疗以及预后的重要评定指标。

Evaluation value of ECG ischemic ST-T changes for severity of acute cerebral infarction and prognosis in aged patients

Objective:To explore evaluation value of ECG ischemic ST-T changes for severity of acute cerebral infarction(ACI)and prognosis in aged patients.Methods:A total of 161 aged ACI patients treated in our hospital were divided into mild group(n=62),moderate group(n=53)and severe group(n=46)according to severity;according to survival condition within 30 dfollow-up,patients were divided into survival group(n=130)and death group(n=31);according to infarct size,patients were divided into lacunar infarction group(n=65),small size infarction group(n=52)and large size infarction group(n=44).All patients underwent ECG examination,relationship among disease severity,prognosis,infarct size and ischemic ST-T changes,and risk factors of death were analyzed.Results:Percentage of no ST-T changes in mild group was significantly higher than those of moderate and severe group(51.61% vs.28.30%,13.04%);percentage of persistent ischemic ST-T changes in severe group was significantly higher than those of mild and moderate group(60.87%vs.20.97%,15.09%),P<0.05 or<0.01.Percentage of persistent ischemic ST-T changes in death group was significantly higher than that of survival group(67.74%vs.21.54%),P=0.001.Percentage of no ST-T changes in lacunar infarction group was significantly higher than those of small and large size infraction group(50.77% vs.26.92%,13.64%);percentage of persistent ST-T changes in large size infraction group was significantly higher than those of lacunar and small size infarction group(61.36%vs.24.62%,11.54%),P<0.01 all.Multi-factor Logistic regression analysis indicated that age>70 years,severity,infarct size and ECG ischemic ST-T changes were independent risk factors for death in ACI patients(OR=2.165~7.862,P<0.05 vs.<0.01).Conclusion:ECG ischemic ST-T changes is associated with prognosis and severity in ACI patients,which can be used as important evaluation indexes for clinical treatment and prognosis.