急性脑血管病并发脑-心综合征的临床研究

目的探讨急性脑血管病并发脑-心综合征的发病机制和防治措施。方法选择急性脑血管病患者30例,对其临床资料进行回顾性分析,观察急性脑血管病并发脑-心综合征的发生率、病变部位、心电图及心肌酶的变化情况,并分析发病机制和防治效果。结果 30例急性脑血管病患者中,并发脑-心综合征17例,发生率56.67%;其中出血性脑血管病并发脑-心综合征的发生率(88.24%)明显高于缺血性脑血管病并发脑-心综合征的发生率(11.76%)(P<0.01)。17例急性脑血管病并发脑-心综合征患者的病变部位位于丘脑、脑干者的发生率明显高于病变部位位于小脑、基底节及脑叶者,差异均有统计学意义(P<0.05,P<0.01);17例并发脑-心综合征患者心电图均有异常改变,心肌酶谱异常15例。经卧床休息、吸氧、扩张冠状动脉、保护心肌功能、纠正水电解质紊乱等综合治疗后,好转16例,好转率94.12%。结论脑-心综合征的发生与急性脑血管病的类型存在相关性,出血性脑血管病高于缺血性脑血管病。在防治脑-心综合征的过程中,应注意加强对急性脑血管病特别是出血性脑血管病患者的心功能监护。

Clinical studies of acute cerebrovascular disease complicating cerebral-cardiac syndrome

Objective To investigate the pathogenesy and prevention and cure measures for acute cerebrovascular disease complicating cerebral-cardiac syndrome.Methods Clinical data of 30 patients with acute cerebrovascular disease were analyzed retrospectively,incidence of cerebral-cardiac syndrome,diseased region,electrocardiogram and changes of myocardial zymogram were observed,nosogenesis and prevention and cure measures were analyzed.Results Cerebral-cardiac syndrome occurred in 17 of all the 30 patients,the incidence rate was 56.67%;the incidence rate of hemorrhagic cerebrovascular disease complicating cerebral-cardiac syndrome(88.24%) was higher than ischemic cerebrovascular disease(11.76%)(P<0.01).The incidence rate of the diseased region in thalamus and brainstem of the acute cerebrovascular disease complicating cerebral-cardiac syndrome patient was higher than the diseased region in cerebellum,basal nuclei and lobe of brain(P<0.05,P<0.01).17 patients all had abnormal electrocardiogram,15 patients had abnormal myocardial zymogram.16 patients turned better by a series treatment of repose,oxygen uptake,intracoronary expansion,protection of myocardial function,correction of electrolyte disturbances,the improvement rate was 94.12%.Conclusion The incidence of cerebral-cardiac syndrome relates to the type of cerebrovascular disease,the incidence of hemorrhagic cerebrovascular disease is higher than ischemic cerebrovascular disease.Myocardial function of hemorrhagic cerebrovascular disease in patients with acute cerebrovascular disease should be paid more attention in clinical work.