80例蛛网膜下腔出血心电图变化与预后关系分析

Analysis of the Relationship between Electrocardiographic Changes and Prognosis of 80 Cases with Subarachnoid Hemorrhage

目的探讨蛛网膜下腔出血(SAH)后心电图改变与预后之间的联系.方法 80例住院动脉瘤性蛛网膜下腔出血的病人,按格拉斯哥预后评分(GOS)标准分为＞3分、≤3分两组.所有的患者经标准12导联心电图检查并计算心电图评分(ES).应用SPSS10.0 统计包分析结果.结果①在年龄、性别、动脉瘤生长部位影响动脉瘤性SAH预后方面,两组病例无明显差异(P＞0.05).而按SAH后Hunt-Hess分级和Fisher分级,GOS＞3病例的分级要明显低于GOS≤3的病例的分级(P＜0.01);②两组在心率、ST段抬高、ST段压低、T波倒置、U波倒置、室性心律失常出现的频率无明显差异(P＞0.05);在异常Q波和室上性心律失常出现频率及心电图评分方面,GOS＞3的组别明显低于对照组(P＜0.05,P＜0.001);③心电图评分是SAH患者预后最显著影响的变量(P=0.002,OR=0.010,95%的可信区间0.001～0.173).结论心电图评分作为一种新型、简便的半定量方法,能有效的预测蛛网膜下腔出血病人的预后.

Objective To investigate the relationship between electrocardiographic changes and prognosis in patients with subarachnoid hemorrhage(SAH). Methods 80 inpatients with SAH caused by ruptured aneurysms were divided into 2 groups:group A,theGlasgow Outcome Scale (GOS) was more than 3;group B,the GOS were less than or equal to 3. All patients had undergone a 12-lead ECG recording and calculated ECG scores. The results were analyzed with the statistical software package SPSS10.0.Results ①Between two groups,there was no significant difference about the affection of age,sex and the destribution and location of aneurism on prognosis outcome( P <0.05).However,the grading of Hunt-Hess and Fisher in group A(GOS>3) showed significantly lower than in group B(GOS≤3),( P <0.001);② There was no significant difference in the frequency of heart rate, ST elevation, ST depression,T wave inversion,U wave inversion and ventricular arrhythmia( P >0.05).The frequency of abnormal Q wave, supraventricular arrhythmia and the ECG scores in group A showed significantly lower than in group B ( P <0.05, P <0.001);③The ECG scores was the most powerful multivariate risk stratified(ECG ≥5 VS ECG<5; P =0.002,OR=0.010,95%CI 0.001~0.173).Conclusion The ECG score, a new and simple method of semi-quantification, was a powerful risk predictor for patients with SAH.