急性脑梗死患者临床分型及梗死面积与心电图改变的关系

Relationship between classification of clinical and infarct size and electrocardiographic changes in patients with acute cerebral infarction

目的探讨急性脑梗死患者临床分型和梗死面积与心电图(ECG)改变的关系。方法给216例急性脑梗死患者进行ECG检查,按牛津郡社区卒中项目(OCSP)分型和梗死面积分型,对各组患者的ECG检查结果进行分析比较。结果OCSP分型完全前循环梗死(TACI)组、部分前循环梗死(PACI)组、后循环梗死(POCI)组和腔隙性梗死(LACI)组患者的ECG异常率分别是:95.5%、80.4%、62.5%和48.5%,TACI组和PACI组明显高于LACI组(P<0.05～0.01);大中面积梗死组(83.7%)的ECG异常率明显高于小面积梗死组(60.4%)和腔隙性梗死组(53.2%)(P<0.05～0.01);小面积梗死组的ECG异常率高于腔隙性梗死组(P<0.05)。OCSP和梗死面积分型各亚型组出现ST-T改变和心律失常的比率差异有统计学意义(P<0.05～0.01)。结论急性脑梗死临床分型病情重和梗死面积大的患者ECG异常率高。

Objective To evaluate the relationship between classification of clinical,the infarct size in patients with acute cerebral infarction and electrocardiographic(ECG)changes.Methods The ECG were done in 216 patients with acute cerebral infarction.ECG results of the patients were analyzed according to classification of the Oxfordshire Commumity Project Criteria(OCSP)and infarct size.Results The rates of ECG abnormality in classification of OCSP were 95.5% for total anterior circulation infarction(TACI),80.4% for partial anterior circulation infarction(PACI),62.5% for posterior circulation infarction(POCI)and 48.5% for lacunar cerebral infarction(LACI).The rates of ECG abnormality of TACI and PACI were signficantly higher than that of group of LACI(P<0.05~0.01).The rate of ECG abnormality of large infarction(83.7%)was significantly higher than those of small infarction(60.4%)and lacunar infarction(53.2%)(P<0.05~0.01).The rate of ECG abnormality of small infarction was significantly higher than that of lacunar infarction(P<0.05).Each subtype of the classification of OCSP and the infarc size were significantly different in ST-T changes and arrhythmias(P<0.05~0.01).Conclusion The severity in the classification of clinical and large infarction have high rates of ECG abnormality.