急性岛叶梗死心电图改变的分析

Electrocardiographic Changes in Patients with Acute Insular Infarction

目的:探讨急性大脑中动脉供血区的脑梗死对心电图改变影响。方法:205例脑梗死患者根据MRI病灶是否累及岛叶分为岛叶梗死组(I组)59例和非岛叶梗死组(NI组)146例。其中I组又分为左侧岛叶组31例和右侧岛叶组28例。回顾性分析205例急性大脑中动脉供血区的非腔隙性脑梗死患者的心电图。结果:I组中出现窦性心动过速7例(11.9%)、异位搏动9例(15.3%)、ST段抬高4例(6.8%)、T波改变13例(22.0%),高于NI组的2例(1.4%)、9例(6.2%)、1例(0.7%)和14例(9.6%),差异有统计学意义(P<0.05或P<0.01)。左右岛叶梗死心电图改变差异无统计学意义(P>0.05)。结论:岛叶可能是影响脑梗死患者心脏自主神经活性和心电图的主要病变部位。急性岛叶梗死易出现心电图的改变。

Objective：To observe electrocardiographic（ECG）changes in patients with acute non lacunar middle cerebral artery （MCA） territory infarction, and analyze the influence of acute insular infarction on ECG. Methods：Two hundreds and five patients with acute non lacunar MCA territory infarction were divided into insular infarction group （I group, 59 cases） and non-insular infarction group （NI group, 146 cases） according to whether the MRI lesions involving the insular region. And I group was further divided into left insular group （31 cases）and right insular group （28 cases）. ECG data of 205 patients were analyzed retrospectively. Results：The ECG changes were manifested by sinus tachycardia （7 cases, 11.9%）, ectopic beat（9 cases, 15.3%）, ST segment elevation （4 cases, 6.8%）and T wave changes （13 cases, 22.0%） in I group compared with those of NI group （2 cases,1.4%; 9 cases,6.2%;1 case,0.7% and 14 case,9.6% respectively,P 0.05 or P 0.01）. There was no significant difference in ECG changes between patients with left and right insular infarction （P 0.05）. Conclusion： The effect of acute cerebral infarction on cardiovascular autonomic function may be mainly correlated with insular lesion. Patients with acute insular infarction are prone to have electrocardiographic changes.