不同部位大脑半球出血对心脏自主神经和心电图的影响

Abnormal eletrocardiogram and heart rate variability in patients with acute hemispheric cerebral hemorrhage

目的:了解不同部位脑出血对心脏自主神经活性、心电图复极改变和心律失常的影响。方法:检测150例不同部位急性大脑半球出血患者和150例对照的心电图和心率变异性,分析其心率变异性变化、心电图复极改变和心律失常。结果:右侧壳核和额顶颞叶出血患者急性期室上性快速心律失常发生率明显增高;左侧壳核和额顶颞叶出血患者急性期心电图段降ST低发生率明显增高。右侧壳核和额顶颞叶出血患者心率变异性指标、、明显下降和明显增高。伴室上HFRMSSDPNN50LF/HF性快速心律失常者和高于无室上性快速心律失常者,明显低于无室上性快速心律失常者。LFLF/HFHF结论:左侧和右侧大脑半球出血对心脏的影响不同,岛叶病变在其中起着主要作用。

Objective:To assess the effect of lesions of cerebral hemorrhage on cardiac damages and cardiac autonomic nervous activity. Methods: ECG and heart rate variability(HRV) recordings were measured and analysed in 150 patients with hemispheric cerebral hemorrhage in the acute phase and in 150 control subjects. Results: Supraventricular arrhythmias were significantly increased in groups of right putamental and frontoparietote-mporal hemorrhage compared with left putamental and frontoparietotemporal hemorrhage and the controls. A significantly increased rate of ST segment abnormalities were found in groups of left putamental and frontoparietotemporal hemorrhage compared with groups of right putamental and frontoparietotemporal hemorrhage and the controls. The measured components of HRV, ie, HF, RMSSD, and PNN50 were significantly lower,and LF/HF were significantly higher in groups of right putamental and frontoparietotemporal hemorrhage in acute phase compared with control group. Conclusion:The effects of hemispheric cerebral hemorrhage on heart function and cardiac autonomic nervous activity are mainly correlated with destruction of insular or regions adjacent to the insular.