脑心综合征168例临床分析

Clinical analysis of 168 cases of cerebrocardiac syndrome

目的:探讨急性脑血管病(ACVD)并发脑心综合征(CCS)的临床特征、发病机制和防治措施。方法:对168例CCS患者的临床资料进行回顾分析。结果:本组急性脑卒中后CCS发生率为35.3%,发生在卒中后1周内的CCS占97%,心脏损害的主要表现为心电图(ECG)的ST-T改变、心律失常、假性心肌梗死样图形以及急性心力衰竭及心肌酶的异常。其发生与卒中类型有关,出血性脑卒中发生CCS(53.5%)明显高于缺血性脑卒中(23.5%)(P<0.01);急性期治疗后好转率为68.5%,死亡率为31.5%。结论:积极降低颅内压(ICP)、保护心脏功能、控制心律失常、心电监测等对患者安全度过急性期有较好的作用。

Objective：To study the clinical characteristics , pathogenesis and treatment of cerebrocardiac syndrome （CCS）. Method：The clinical data of 168 cases of CCS were analyzed retrospectively. Result：The incidence rate of CCS was 35. 3% . Most cerevrocardiae syndrome（97%）oceurred in the first week of stroke. The main manifestation of the heart, damage were the ST -- T change of Electrocardiogram,arrhythmia,similarity myocardial infarction graph of ECG , acute heart failure and the abnormality of myocardial enzyme. The occurrence of CCS was associated with the stroke type. CCS was found more common in hemorrhagic stroke （53.5%） than that in embolic stroke （23.5%） （ P 〈0.01）. The improved rate was 68. 5% after treatments. The mortality rate was 31.5%. Conclusion：Decreasing high ICP, protecting the heart function,controlling the arrhythmia and EKG monitoring may be helpful for the patients to pass the acute period.