急性脑出血患者心电图改变与预后关系

Relation between changes of ECG and prognosis of patients with acute cerebral hemorrhage

目的探讨急性脑出血患者心电活动异常的发生率及其与出血部位、出血量和预后的关系。方法回顾分析2007-01~2008-06入住我院的164例发病3 d内脑出血患者心电图改变的特点及相关临床资料,比较ECG异常的与出血部位、出血量组关系,对比死亡组与存活组心电图异常率。结果126例(76.8%)脑出血急性期患者出现一个或一个以上的心电图异常。脑干出血者心电图异常率最高,脑干出血患者心电图异常率显著高于非脑干部位出血及基底节区出血患者(P<0.05)。84例基底节区脑出血中,大量出血组的患者心电图异常率与小量出血相比差异有统计学意义(P<0.05)。死亡组与存活组心电图异常率差异无统计学意义(P>0.05)。结论在脑出血后常出现ECG异常,脑干出血ECG异常率最高,基底节区脑出血中大量出血ECG异常率高,ECG异常可能并不直接影响脑出血患者的短期预后。

Objective To investigate the relation between changes of ECG in patients with intracerebral hemorrhage （ICH）, and the hematoma location, hematoma volume and prognosis. Methods Total 164 patients with ICH admitted to our hospital from Jan. 2007 to Jun. 2008 were retrospectively studied. ECGs and cranial CT obtained within 3 days after the initial hemorrhage were analyzed. The relationship between ECG changes and the hematoma location, hematoma volume, and the clinical outcomes were analyzed. The incidence of ECG abnormalities between death group and survival group was compared. Results Of the 164 patients with acute cerebral hemorrhage, 126（76.8）cases had abnormal ECG. The incidence of ECG ab-normality in brain stem hemorrhage patients was higher non- brain stem hemorrhage patients, basal nuclei area hemorrhagepatients（P^O. 05）. Among 84 patients with basal nuclei area hemorrhage, the incidence of ECG abnormality in massive hem- orrhage group was higher than small amounts group（P〈0.05）. There was no significant difference in the incidence of ECG ab- normality between the death group and the survival group （P〉0.05）. Conclusion In acute intracerebral hemorrhage patients, ECG abnormalities are common. The incidence of ECG abnormality of brain stem hemorrhage patients was highest. Among the patients with basal nuclei hemorrhage, the incidence of ECG abnormality in massive hemorrhage group is high. The patients with abnormal ECG may not influence the early outcome.