卒中后的心肌缺血样损伤

目的　研究卒中后急性期心肌缺血样损伤的发生情况及对预后的影响。方法　以既往无心脏病史的卒中急性期患者为研究对象 ,发病 3d内及 15d后进行心电图 (ECG)检查 ,统计分析ECG出现缺血样改变的发生率及恢复率。以发病 3d内ECG出现缺血样改变患者为缺血组 ,ECG无明显异常者为对照组。统计分析死亡率差别。结果　蛛网膜下腔出血(SAH)后伴有ECG心肌缺血样表现的患者死亡率明显升高 (P <0 0 1)。脑梗死 (CI)或脑出血 (CH)伴有ECG心肌缺血样表现的患者死亡率无明显改变。存活患者中 ,这种ECG心肌缺血样改变短期内恢复的比率较低 ,且SAH的恢复率高于CH和CI(P<0 0 5 )。结论　急性卒中可导致心肌暂时性或长期性损伤 ,这种损伤可导致SAH患者死亡率升高

Myocardial ischemic damage after acute stroke

Objective To investigate the occurrence of myocardial ischemic damage after acute stroke including SAH,CI,CH and the influence on the prognosis of stroke Methods We had investigated 365 acute stroke patients with no preexisting cardiac disease ECG examinations were carried out in the first 3 days and 15 days after onset of symptoms The patients with ischemic-like change of ECG in the first 3 days were taken into positive group, and the others into control Data were statistically analysed Results The mortality in SAH patients with ischemic-like change of ECG was significantly higher than that in the control(P<0 01), there was no significant difference in CI and CH patients The recovery of abnormal ECG was significantly higher than in CI and CH patients, whereas they were all very low (P<0 05) Conclusion Acute stroke might induce temporarily or long-term myocardial ischemic damage, and our data show the correlation between the damage and the higher mortality in SAH