急性脑血管病合并脑心综合征92例分析

目的探讨脑心综合征的临床特点及发病机制。方法回顾分析92例急性脑血管病(ACVD)并发脑心综合征的临床资料。结果ACVD患者脑心综合征的发生率为63.01%,大部分脑心综合征患者在ACVD两天内发病,多数于两周内随病情改善而好转;心脏损害的表现主要为心电图的复极异常、心律失常以及心肌酶谱不同程度的升高。出血性卒中、近中线结构的损害及意识障碍的患者并发脑心综合征发生率更高。结论其发生机制可能与脑特定部位受损导致对心脏神经支配紊乱,神经、体液调节障碍,血管病变及血流动力学变化等有关。应对ACVD加强心脏监护,积极诊治脑心综合征。

Report of 92 cases of cerebral-cardiac syndromes in patients with acute cerebrovascular diseases

Objective To investigate the clinical characteristics and pathogenesis of cerebral-cardiac syndromes(CCS) in patients with acute cerebrovascular diseases(ACVD).Methods The clinical data of 92 cases of CCS in patients with ACVD were reviewed and analyzed.Results The incidence of CCS was 63.01% in ACVD patients,and most of them were attacked with CCS within 2 days after ACVD onset.As ACVD was controlled,CCS was ameliorated gradually in 2 weeks.The main manifestations of myocardial lesion were re-polarization abnormality,arrhythmia on ECG as well as varying degrees of increase in cardiac enzymes.In ACVD patients who suffered from hemorrhagic stroke,injury of structures near median line or disturbance of consciousness,the incidence of CSS was significantly higher than in others.Conclusion Pathogenesis of CSS may be related to the disturbance of cardiac innervation,neural and humoral regulation,vascular lesion,hemodynamic disorders which may result from the lesion in specific part of brain.Heart monitoring should be strengthened in ACVD and CSS should be diagnosed and treated actively.