505例原发性蛛网膜下腔出血的心电图改变

The Change of Electrocardiogram in 505 Cases of Primary Subarchnoid Hemorrhage

本文就５０５例原发性蛛网膜下腔出血病人的心电图进行分析。根据心电图表现，将病人分为２组。其中心电图正常组（Ｉ组）１４９例（２９．６％），心电图异常组（Ⅱ组）３５６例（７０．４％）。在心电图异常组中，窦性心动过速发病率最高，共１３９例（３９％），以后按发病率依次为：Ｓ—Ｔ段降低９３例（占２６％），左室肥大９２例（２５．８％），窦性心动过缓、Ｔ波低平、倒置各７５例（各占２１％）。其他心律失常如阵发性心动过速，房性早搏，室性早搏等较少。研究结果还提示，伴有心电图异常的原发性蛛网膜下腔出血病人预后较差。另一方面，将Ⅱ组病人中复查心电图有改善病人的死亡率与复查心电图后无改善或恶化病人的死亡率进行比较，前者比后者明显低，经统计学处理，有非常显著性差异（Ｐ＜０．００１）。提示心电图的改变可作为原发性蛛网膜下腔出血病人预后判断的一个重要指标。

The menifestation of electrocardio-gram(ECG) of 505 cases of primary subarachnoid hem-orrhage were analysed in this article According to ECG,the epatients were divided into two groups.There were149 cases(29.6%) in ECG normal group(I group),and 356 cases(70.4%)in ECG abnormal group(Ⅱgroup). In Ⅱgroup,the insidence of sinus tachycardiawashghest,accounted for 139 cases(39%).The insid-ences of othcr ECG abnormal were ranged successivelyas following:S-T segment depression was accountedfor 93 cases(26%);left ventricular hypertrophy wasaccounted for 97 cases(25.8%); sinus bradycardia,Twave low-flat and Twave inversiOn were accounted for75 cases(21%) respectlvely;left ventricular hyervolt-age was accounted for 50 cases(16 %).Other arrhyth-mia such as paroxyxmal tachvcardia ventricular or atrialpremature beat etc were less.The results of our study al-so suggested that the pstients sufer from primary sub-arachnoid hemorrhge complicated by ECG abnormalhad bad prognosis.Another side, comparing the mortali-ty of patients in Ⅱ group whom had ECG improving inre-examination to of patients in the same group whomhad ECG unimproving or deteriorating in re-examina-tion.the former was more lower.it thowed a very obvi-ous difference by statistics(P<0. 001).It suggestedthat the change of ECG may be taken as an importantprognosis judge index for primary subarachnoid hemor-rhage.