脑血管病患者介入诊疗与心电图异常的临床研究

Clinical Study of Abnormal Changes in Electrocardiograph After Interventional Diagnosis and Treatment of Patients With Cerebrovascular Disease

目的：探讨介入诊疗对脑血管病患者心电图异常改变的影响。方法选取2011年1月—2014年2月湖州市中心医院神经内科住院行介入诊疗的脑血管病患者635例，根据脑血管病类型分为缺血性脑血管病组481例，出血性脑血管病组154例，于介入诊疗操作前、后进行心电图检查，并结合年龄、脑血管病类型等进行分析。结果635例患者中发现明确心电图异常403例，异常率为63.5％。＜45岁患者发现心电图异常13例（14.6％），45～60岁患者发现心电图异常80例（38.1％），＞60岁患者发现心电图异常310例（92.3％），不同年龄段患者心电图异常率比较，差异有统计学意义（χ2＝5.52， P＜0.01）。缺血性脑血管病组患者发现心电图异常362例（75.3％），出血性脑血管病组患者发现心电图异常41例（26.6％），差异有统计学意义（χ2＝119.00， P＜0.01）。介入诊疗操作前、后，缺血性脑血管病组患者心电图异常率均高于出血性脑血管病组（ P＜0.05）。缺血性脑血管病组患者介入诊疗操作后心电图异常率与介入诊疗操作前比较，差异无统计学意义（ P＞0.05）；出血性脑血管病组患者介入诊疗操作后心电图异常率高于介入诊疗操作前（ P＜0.05）。结论介入诊疗与脑血管病患者的心电图异常有关，完善心电图检查，能够及时了解脑血管病患者接受介入诊疗操作过程中的心脏风险。

Objective To investigate the abnormal changes of electrocardiogram （ ECG） after interventional diagnosis and treatment of patients with cerebrovascular disease .Methods We enrolled 635 patients with cerebrovascular disease who were admitted into the Department of Neurology of Huzhou Central Hospital and received interventional diagnosis and treatment there from January 2011 to February 2014.According to the type of cerebrovascular disease , 481 patients were assigned into ischemic cerebrovascular disease group and 154 patients were assigned into hemorrhagic cerebrovascular disease group .Before and after interventional diagnosis and treatment , ECG examination was conducted , and the ECG results were analyzed in combination with age and the type of cerebrovascular disease .Results Of the 635 patients, abnormal changes of ECG occurred in 403, with an abnormality rate of 63.5%.Among patients younger than 45, 13 （14.6%） patients had abnormal changes in ECG; among patients aged 45 to 60, 80 （ 38.1%） had abnormal changes in ECG; among patients older than 60, 310 （ 92.3%） had abnormal changes in ECG.Patients of different age ranges were significantly different （χ2 =5.52, P〈0.01） in the abnormality rate of ECG.In ischemic cerebrovascular disease group , abnormal ECG changes occurred in 362 （75.3%） patients, and in hemorrhagic cerebrovascular disease group , abnormal ECG changes occurred in 41 patients （ 26.6%） , with significant difference between the two groups （χ2 =119.00, P〈0.01） .Before and after interventional diagnosis and treatment , ischemic cerebrovascular disease group was higher （ P〈0.05 ） than hemorrhagic cerebrovascular disease group in the abnormality rate of ECG.The abnormality rate of ECG of ischemic cerebrovascular disease group after interventional diagnosis and treatment was not significantly different （ P 〉0.05 ） from that before interventional diagnosis and treatment; the abnormality rate of ECG of＆amp;nbsp;hemorrhagic cerebrovascular disease group was higher （ P 〈0.05 ） than that before interventional diagnosis and treatment.Conclusion Interventional diagnosis and treatment is related with ECG abnormality .The perfection of ECG examination could timely find the cardiac risk during interventional diagnosis and treatment of patients with cerebrovascular disease.