重复12导联心电图检查对老年缺血性脑卒中患者阵发性心房颤动的筛查

Role of repeated ECG in detecting paroxysmal artrial fibrillation in elderly acute ischemic stroke patients

目的通过对急性缺血性脑卒中伴阵发性心房颤动(房颤)患者进行筛查,研究反复多次心电图检测的方法是否可以提高其筛查阳性率。方法选择2016年1月1日~12月31日南京卒中注册系统中既往无房颤史的缺血性脑卒中急性期患者745例,志愿配合加强心电图检测的患者277例作为实验组,行常规检查之外连续4d加强普通心电图检测,并分析心电图结果。同时期其他无房颤史缺血性脑卒中急性期患者468例作为对照组。比较2组阵发性房颤发生率。结果 2组年龄、性别、高血压、糖尿病、吸烟、饮酒、脑卒中或短暂性脑缺血发作史、白细胞计数、TG、国际标准化比值、美国国立卫生研究院卒中量表评分和CHADS2评分比较,差异无统计学意义(P>0.05)。实验组阵发性房颤发生率明显高于对照组(9.0%vs 3.8%,P=0.003)。结论心电图反复多次检测可以明显提高老年缺血性脑卒中急性期阵发性房颤检出率。

Objective To study whether ECG can effectively detect paroxysmal artrial fibrillation（PAF）in elderly acute ischemic stroke（AIS）patients.Methods Seven hundred and forty-five elderly AIS patients with no history of artrial fibrillation were divided into experimental group（n=277）and control group（n=468）.The ECG findings and incidence of PAF were compared between the two groups.Results No significant difference was found in age,gender,history of hypertension,diabetes mellitus,alcohol comsumption,ischemic stroke and transient ischemic stroke attack,WBC,serum TG level,international standard ratio,NIHSS and CHADS2 score between the two groups（P〈0.05）.The incidence of PAF was significantly higher in experimental group than in control group（9.0%vs 3.8%,P=0.003）.Conclusion Repeated ECG can effectively detect PAF in elderly AIS patients.