不同部位急性脑梗死早期心电图改变的临床意义

Clinical significance of early changes of ECG in patients with different parts of acute cerebral infarction

目的探讨急性脑梗死患者早期心电图改变的临床意义。方法分析304例急性脑梗死患者的心电图资料。结果①304例患者中发生早期心电图异常占64.47%,表现为ST-T改变、窦性心律失常、Q-T间期延长、起搏点异常和传导异常。②岛叶梗死组早期心电图异常显著多于非岛叶梗死组(81.97%、52.75%,P<0.01)。③中、重型患者在心电图异常组显著多于无心电图异常组(96例、5例熏P<0.01雪,岛叶梗死组显著多于非岛叶梗死组(68例、28例熏P<0.01)。④心电图异常的岛叶梗死组死亡率显著高于非岛叶梗死组(17例、2例熏P<0.05)。结论急性脑梗死早期心电图异常与梗死部位、病情严重程度及预后有关,而岛叶梗死患者的心电图异常发生率高、病情重及预后差。

Objective To evaluate clinical significance of early changes of ECG in patients with different parts of acute cerebral infarction. Methods ECG data of 304 patients with acute cerebral infarction was analyzed. Results ① 64.47% cases had early abnormal changes of ECG which manifested as ST-T change, sinus arrhythmia, prolong of Q-T interval, abnormal pacing source and conduction. ②Number of patients with early abnormal changes of ECG was significantly more in insula infarction group than in non-insula infarction group （81.97% vs. 52.75%, P〈0.01 ）. ③Number of patients with middle to severe infarction was significantly more in abnormal ECG group than in normal ECG group （96 cases vs. 5 cases, P〈0.01） and was significantly more in insula infarction group than in non-insula infarction group （68 cases vs. 28 cases, P〈0.01）.④ Mortality of patients with abnormal ECG was higher in insula infarction group than in non-insula infarction group （17 cases vs. 2 cases, P〈0.01）. Conclusion Early abnormal changes of ECG in acute cerebral infarction is related to location, severity and prognosis of infarction. Patients with insula infarction have more abnormal ECG changes and worse prognosis.