急性脑血管病心电图特点及分析论著

目的分析急性脑血管病心电图异常的特点,并讨论其发生的机制。方法对249例经头颅CT确诊为急性脑血管病患者在入院24 h内做标准导联心电图检查。结果 249例患者心电图的异常率为69.1%(172/249),其中脑出血异常率64.3%(18/28);脑梗死异常率69.7%(154/221),两者比较差异无统计学意义(P<0.05)。ST-T改变的发生率最高,其次为传导阻滞,与Q-T间期延长、p波增宽、左心室肥厚、心律失常、低电压比较差异有统计学意义(P<0.05)。心电图正常组病死率1.3%(1/77),心电图异常组病死率7.6%(13/172),两组病死率比较差异有统计学意义(P<0.05)。结论急性脑血管病患者中心电图异常发生率较高,以心肌缺血和传导阻滞为主。心电图异常组病死率高,临床工作中应关注急性脑血管病患者的心电图改变,及时给予适当处理。

The analysis of clinical characteristics of electrocardiogram of acute cerebrovascular disease

Objective To analyze the characteristics of electrocardiogram （ECG） abnormalities of acute eerebrovascular diseases, and discuss its mechanism. Methods Two hundred forty - nine eases of acute cerebrovascular disease diagnosed by brain CT were involved in the study. The patients received standard lead ECG within 24h hospitalization. Results Of 249 patients with cerebrovascular diseases the abnormal ECG rate was 69.1% （ 172/249 ） ; it was 64.3% （ 18/28 ） for cerebral hemorrhage and 69.7% （ 154/221 ） for cerebral infarction. ST - T change was most common, followed by conduction block, Q - T interval prolongation, broad P wave, left ventrieular hypertrophy, arrhythmia, and low voltage （ P 〈0.05）. The mortality in ECG abnormal group （13/172, 7.6% ） was significantly higher than that in ECG normal group （1/ 77, 1.3 % ） （ P 〈 0.05 ）. Conclusion The incidence of ECG abnormalities in patients with acute cerebrovascular diseases is high and the main abnomalities are myocardial ischemia and conduction block. The mortality is higher in patients complicated with abnormal ECG. Clinical workers should give the timely treatment for the patients with acute cerebrovaseular diseases and ECG abnormal changes.