急性脑梗死对心率变异性、QT离散度及心室晚电位的影响

Effects of acute cerebral infarction on heart rate variability,QT dispersion and ventricular late potential

目的探讨脑梗死及其梗死部位、病情严重程度对心脏电活动的影响。方法选择急性脑梗死患者107例为病例组,同期体检健康者79例为健康对照组。分析两组病例中前循环梗死患者与后循环梗死患者及轻症梗死患者与重症梗死患者之间心率变异性(heart rate variability,HRV)指标R-R间期标准差(standard diviation of normal to normal intervals,SDNN)、QT间期离散度(QT dispersion,QTd)及心室晚电位(venticular late potential,VLP)阳性率的差别。结果脑梗死患者的SDNN低于健康对照组,而QTd及VLP阳性率高于健康对照组,差异均有统计学意义(P<0.01)。后循环梗死患者的SDNN低于前循环梗死患者,差异有统计学意义(P<0.05);而其QTd及VLP阳性率高于前循环梗死患者,差异有统计学意义(P<0.01)。重症梗死患者的SDNN低于轻症梗死患者,而QTd及VLP阳性率高于轻症梗死患者,差异有统计学意义(P<0.01)。结论脑梗死及其梗死部位、病情严重程度可影响心脏电活动。脑梗死患者,尤其是后循环梗死及重症梗死患者,其SDNN减低,而QTd及VLP阳性率增高。

Objective To investigate the effect of acute cerebral infarction and its location and severity on heart electric activity. Methods One hundred and seven patients with acute cerebral infarction （CI） and 79 healthy persons on physical examinations as con- trois were entered into the study. The difference of standard diviation of NN intervals （SDNN） which demonstrates the heart rate variabili- ty（HRV）, QT dispersion（QTd）, and ventrieular late potential （VLP） was analysed between patients with CI and healthy controls, be- tween patients with CI in anterior circulation and those in posterior circulation, and between patients with mild CI and those with severe CI. Results SDNN in patients with CI was significantly lower,while QTd and the positive rate of VLP were significantly higher, than those in healthy controls（ P 〈 0.01 ）. SDNN in patients with CI in posterior circulation was significantly lower（ P 〈 0.05 ） ,while QTd and the positive rate of VLP were signifieantly higher（P 〈0.01 ）, than those in patients with CI in anterior circulation. SDNN in patients with severe CI was significantly lower, while QTd and the positive rate of VLP were significantly higher, than those in patients with mild CI （ P 〈 0.01 ）. Conclusions CI as well as its loeation and severity can influnce the heart electric activity. HRV in patients with CI , especial- ly in those with CI in posterior circulation or in severe condition ,tends to be lower while QTd and the positive rate of VLP tend to be higher.