脑出血后脑心综合征心电生理和心肌酶学的动态观察

Dynamic observation on changes of DCG and myocardial enzyme in cerebrocardiac syndrome after acute cerebral hemorrhage

目的:探讨急性脑出血致脑心综合征的动态心电图及心肌酶谱的改变及其临床意义。方法:对115例急性脑出血患者行Holter检查,测定85例患者磷酸肌酸激酶同工酶(CK-MB)及心肌肌钙蛋白I(cTn-I),并与59例健康体检者进行对照。结果:脑出血后心电图改变类型最常见的为ST-T改变,丘脑及基底节区、脑干和小脑与脑叶ST-T改变比较差异有统计学意义(P<0.01)。脑出血患者,血清CK-MB除病后7d外,在病后3～48h、3d均增高,血清cTn-I各组均增高,与对照组比较差异均有显著性(P<0.05或P<0.01)。结论:急性脑出血患者心电图及心肌酶谱异常发生率较高,对其进行测定可能有助于脑心综合征的防治及病情的判断。

Objective：To study the characteristic of dynamic electrocardiogram（DCG） and myocardial enzymes in cerebrocardiac syndrome after acute cerebral hemorrhage. Methods： Holter examinations were done in 115 cases of acute cerebral hemorrhagic patients, Phosphocreatine kinase isozyme （CK-MB） and cardiac troponin Ⅰ （cTn-Ⅰ） were detected in 85 cases of patients and compared with 59 healthy controls. Results： The most common change in DCG after cerebral hemorrhage was ST-T alteration. There was statistic significance in group of hemorrhage at thalamus, basal nuclei, brainstem and cerebellum than that in group of lobes. That the levels of serum CK-MB and cTn-Ⅰ mere increased in 3- 48 hour and 3 days except the seven days of onset after cerebral hemorrhage in the group of cerebral hemorrhage was obviously higher than that of the control group （P〈0.01）. Conclusion： The incidence rates of abnormal DCG and myocardial enzyme abnormality were higher in acute cerebral hemorrhagic patients. Measurement of DCG and myocardial enzyme may be helpful for the prevention and cure of cerebrocardiac syndrome.