延髓闩部肿瘤与其他部位脑肿瘤心电图改变的对比研究

Comparison of Electrocardiographic Changes in Patients With Brain Tumors Involved in Medulla Obex and Other Regions

目的 :比较延髓心血管调节中枢受累和其他部位脑肿瘤的心电图改变 ,探讨不同部位脑肿瘤与心电图改变之间的关系及其发生机制。方法 :15 2例脑肿瘤患者分成延髓组、边缘系统组、非边缘系统组 ,分别对其术前心电图进行观察、测量、统计学处理。结果 :48%的患者有心电图异常。延髓组边缘系统组与非边缘系统组比较心电图异常率、校正后的QT间期 (QTc间期 )异常、QTc间期均值、ST段异常、T波异常及窦性心动过速发生均有显著性差异 (P <0 0 5 )。心率延髓组较边缘系统组和非边缘系统组增快 ,有显著性差异 (P <0 0 5 )。结论 :延髓闩部心血管调节中枢受累 ,可以使副交感神经受到抑制 ,交感神经系统兴奋性异常增高 ,产生心率增快、复极障碍为主的心电图改变 ,心电图异常率明显增高。边缘系统损害产生与延髓受累相似的心电图改变 ,非边缘系统组心电图改变与延髓组有显著差异 ,表明脑损害部位与心电图改变之间存在相关性。

Objective:To investigate the electrocardiographic changes in patients with medulla tumors involved in cardiovascular center of obex and brain tumors in other regions,and to examine the correlation of the affected regions to the electrocardiographic (ECG) changes. Methods:One hundred fifty two patients were divided into three groups,medulla group,limbic system group and non limbic system group The ECG changes before operation were analyzed. Results:ECG abnormalities were found in 48% of the patients The incidence of abnormal ECG,incidence of abnormal QTc intervals,mean QTc interval,abnormal ST segments,abnormal T waves and sinus tachycardia in medulla group and limbic system group were significantly higher than those in the non limbic system group( p <0 05) Heart rate in medulla group was significantly higher than those in the non limbic system group and the limbic system group ( p <0 05). Conclusion:The increased irritability of sympathetic nervous system and inhibition of parasympathetic nervous system resulted from tumors induced damage of cardiovascular center at medulla obex.The ECG changes of medulla group were significantly different from non limbic system group and simillar to limbic system group.These data show there is a correlation between abnormal ECGs and the damaged regions of the brain.