脑心综合征患者的心电图及心肌损伤标志物的变化

Change of electrocardiogram and markers of myocardial injury in patients with cerebro-cardiac syndrome

目的探讨脑卒中患者发生脑心综合征时,心电图(ECG)与心肌酶谱、肌钙蛋白-T(CTnT)等心肌损伤标志物的变化及意义。方法检测发生脑心综合征的135例脑卒中患者的ECG、心肌酶谱与CTnT,并对不同损伤部位、不同病种的临床资料进行分析。结果脑卒中后ECG改变在病后1周内发生率84.4%,其与脑损害部位有关,靠近基底节及丘脑的部位病变时其心电图异常率高;丘脑损伤以早搏多见,延髓损伤以心动过缓多见,而基底节区则以快速型心律失常多见;心肌酶谱异常者CK-MB升高为55.5%,肌钙蛋白T 24 h内升高者46.7%。结论脑心综合征表现为早期心电图异常与心肌损伤标志物的升高。

Objective To investigate the change and significance of electrocardiogram（ECG） and markers of myocardial injury such as myocardial enzymes and troponin-T （CTnT） in affected patients with cerebrocardiac syndrome （CCS） caused by cerebral stroke. Methods In one hundred and thirty-five patients with CCS, the ECG, myocardial enzymes and CTnT, and clinical data of different injury parts and different kinds of diseases were analyzed. Results The inci- dence of ECG changes within 1 week after stroke was 84.4%. The parts of the brain damage were related to the site near the basal ganglia and thalamus lesions of its high rate of abnormal electrocardiogram; Hypothalamic injury was common to premature beats, damage to heart over the medullary bradycardia was more commonly, while the basal ganglia of tachyarrhythmia; abnormal myocardial enzyme CK-MB increase was in 55.5%, troponin T 24 hours, increased in 46.7%. Conclusion Early abnormal electrocardiogram changes and makers of myocardial injury occurs in cerebro-cardiac syndrome.