急性岛叶梗死的临床特征分析

Clinical characteristics analysis of acute insular infarction

目的探讨急性岛叶梗死的临床症状、体征及其对心电图和心肌酶谱的影响。方法回顾性分析31例急性岛叶梗死患者的临床症状、体征和心电图及心肌酶谱改变。结果急性岛叶梗死临床表现为语言障碍、偏瘫、感觉障碍、高级智能活动减退及假性前庭症状,部分患者最终发展为大面积脑梗死;心电图改变表现为ST-T异常、心动过缓、左前分支传导阻滞、Q-T间期延长、室上性心动过速、心房纤颤等;心肌酶谱改变主要为乳酸脱氢酶、肌酸激酶、肌红蛋白、心肌肌钙蛋白异常。结论急性岛叶梗死临床症状复杂、个体变异大,部分进展为大面积脑梗死,且容易引起心血管不良事件,甚至可导致猝死,应引起临床医师的重视。

Objective To investigate the clinical symptoms of the acute insular infarction, physical signs and its influence on the ECG and myocardial enzyme spectrum. Methods A retrospective analysis of the clinical symptoms of 31 patients with acute insular infarction, signs and electrocardiogram and myocardial enzyme change. Results The clinical manifestations of acute insular infarct as language barriers, hemiplegia, sensory disturbance, advanced intelligent activity drops and pseudo vestibular symptoms, some patients eventually develop into a large area cerebral infarction; ECG showed ST-T abnormal, heartbeat bradycardia, left anterior hemiblock, prolongation of the Q-T interval, ventricular heartbeat tachycardia, arterial fibrillation; Myocardial enzyme changes mainly for lactate dehydrogenase, creatine kinase, myoglobin, cardiac troponin abnormal. Conclusions Acute insular infarction clinical symptom complex, large individual variation, some progress for large area cerebral infarction, and easy to cause cardiovascular abnormalities, and even can lead to sudden death, should cause the attention of clinicians.