出血程度对动脉瘤性SAH继发心脏损害的影响研究

Research on relationship between severity of SAH and secondary heart damage in aneurysmal SAH patients

目的探讨出血程度与动脉瘤性SAH继发心脏损害的发生之间的关系。方法将80例动脉瘤性SAH患者,根据FisherCT分级情况,随机分成轻度(Fisher1、2级)和重度(Fisher3、4级)出血两组,进行发病早期(1周内)动态的心电图及心肌酶与心肌结构蛋白监测,分别观察心脏损害发生的情况。结果38例轻度出血组患者中,早期心电图异常24例(ST-T改变者10例),心肌酶与结构蛋白异常13例;42例重度出血组患者中,早期心电图异常37例(ST-T改变者26例),心肌酶与结构蛋白异常24例。两组间心电图与心肌酶及结构蛋白异常发生率不同,差异有显著性(P<0.05)。结论出血程度与动脉瘤性SAH继发心脏损害的发生明显相关,Fisher分级高者(3、4级)发生继发心脏损害的危险性明显高于分级低者(1、2级),且继发心脏损害的发生与患者的临床预后相关。

[Objective] To investigate the relationship between severity of subarachnoid hemorrhage（SAH） and seeondary heart damage in aneurismal SAH patients. [Method] 80 aneurysmal SAH patients were divided into two groups aeeording to their Fisher Grade：minor SAH group （Fisher Grade 1-2） and severe SAH group（Fisher Grade 3- 4）.Early ECG ehanges and myocardial enzyme and structural protein abnormality were monitored and recorded to evaluate severity of heart damage. [Result] In 38 cases with minor SAH, 24 showed early ECG abnormolity （10 with ST-T change） and 13 showed abnormality of myocardial enzyme or structural protein. While in 42 cases with severe SAH, 37 showed early ECG abnormolity （26 with ST-T change）, 24 showed abnormality of myoeardial enzyme or structural protein. The rate of ECG and myocardial enzyme or structural protein abnormality are signifeantly different between the two groups （P 〈0.05）. [Conclusion] In aneurysmal SAH patients, the severity of SAH has significant influenee on secondary heart damage which may influence patients outcome. The risk of heart damage in patients with high Fisher grade is much higher than those with low Fisher grade.