老年脑梗死患者的无症状心肌缺血

Silent myocardial ischemia in elderly patients with cerebral infarction

研究老年脑梗死患者无症状心肌缺血 (SMI)的发生率、脑梗死部位与SMI的关系 ,并对SMI的发生机制进行探讨。方法 对 146例既往无冠心病史的老年脑梗死患者SMI的发生率、脑梗死部位与SMI的关系、脑梗死病情轻重与SMI的关系及SMI患者的心电图演变进行分析。结果 老年脑梗死患者SMI的发生率为 5 8.9% ;脑干及丘脑部位的病变SMI的发生率最高 ,基底节区及皮层次之 ;80 .2 %的SMI患者心电图的异常随着脑梗死病情的好转而完全恢复正常 ;发生SMI的老年脑梗死患者预后差。结论 老年脑梗死患者易伴发SMI,两者互相影响病情和预后。对脑梗死患者早期检出SMI,能改善脑梗死患者的预后。

Objective To explore the incidence of silent myocardial ischemia (SMI)、the relation between location of cerebral infarction and SMI in elderly patients with cerebral infarction.Methods The incidece of SMI,relations between location of cerebral infarction and SMI and between severity of cerebral infartion and SMI were analyzed in 146 elderly patients with cerebral infarction but without the history of coronary heart disease.Results The incidence of SMI in elderly patients with cerebral infarction was 58.9% and the incidence of SMI was highest in the patients with infarction in the brainstem and thalamus.With the recovery of cerebral infarction,the changes in electrocardiogram returned to normal gradually in of the 80.2% of the patients with SMI.The prognosis of patients with cerebral infarction accompanied by SMI was worse than those without SMI.Conclusions The incidence of SMI in elderly patients with cerebral infarction was very high.Patients with SMI should be identified and treated because of their relatively poor prognosis.The early discovery of SMI in patients with cerebral infarction may improve the prognosis of the cerebral infarction.