老年急性脑血管病后脑心综合征发生相关因素：附243例分析

目的探讨老年急性脑血管病后脑心综合征临床特点，并提出防治措施。方法对我院内科2007年12月-2011年11月收治的243例老年急性脑血管病临床资料进行回顾分析，了解脑心综合征发生率及发生相关因素、临床特点。结果243例中脑他死202例（脑梗死组），脑出血41例（脑出血组），共发生脑心综合征102例，总发生率42．0％，脑梗死组心电引异常发生率39．1％，脑m血组心电图异常发生率56．1％，两组比较差异有统计学意义（P〈0．05）。102例中23例心电图也肌酸激酶同工酶、肌钙蛋白均异常.脑心综合征心电图表现以ST-T改变最为突出，其次是心律失常。进一步分析显示脑血管病变部位在基底核、丘脑和脑干者更易发生脑心综合征。结论老年急性脑血管病后脑心综合征发生与脑血管病类型、部位有一定关系，发生机制可能与脑血管病直接或间接导致植物神经中枢功能失调和神经体液调节功能紊乱等有关。

Correlation Factors of Cerebrocardiac Syndrome in Elderly Patients with Acute Cerebrovascular Disease ( Clinical Analysis of 243 Cases)

Objective To explore the clinical features of cerebrocardiac syndrome in elderly patients with acute cerebrovascular disease and propose some preventive measures.Methods Clinical data of 243 elderly patients with acute cerebrovascular disease during December 2007 and November 2011 were retrospectively analyzed in order to learn the incidence rate,correlative factors and clinical features of cerebral-cardiac syndrome.Results There were 202 patients with infarction of the brain(Group 1) in 243 patients,and there were 41 patients with cerebral hemorrhage(Group 2),and 102 patients(42.0%) were diagnosed as having cerebrocardiac syndrome(CCS).The incidence of ECG abnormal in group 1 was 39.1%(79/202),while that of group 2 was 56.1%(23/41).The difference of the two groups was statistically significant(P<0.05),the abnormal ECG and creatine kinase isoenzyme were found in 23 patients of the 102 patients with CCS.The ECG of CCS indicated the change of ST-T and arrhythmia.Cerebrovascular lesion in the basal nuclei,thalamus and brainstem evoked the CCS easily by further analysis.Conclusion The symptom of CCS in elderly patients with acute cerebrovascular disease are related to the type or position of it.Pathogenesis of CSS may be related to the dysfunction of autonomic nervous center directly or indirectly led by cerebrovascular disease and the disturbance of neural and humoral regulation.