老年急性缺血性脑梗死患者心电图ST-T变化及其临床应用价值

Changes of ST-T in electrocardiogram in elderly patients with acute ischemic infarction and its relationship with the severity of illness

目的:探讨老年急性缺血性脑梗死患者以缺血性ST-T改变为主的动态心电图特征及其与病情严重程度之间的相互关系,为病情诊断及预后提供理论依据。方法:选择2013年1月至2015年12月收治的老年急性缺血性脑梗死患者中筛查出83例ST-T改变者,均行头颅CT和常规心电图检查,并按心电图检查结果,分为持续性缺血ST-T改变组(16例)、短暂性缺血ST-T改变组(44例)和无缺血性ST-T改变组(23例),分析ST-T动态变化下的心电图特征并分别比较3组患者重度、中度、轻度病情下的心电图异常发生率,以及与梗死灶大小、预后之间的关系。结果:本组患者心电图特征以缺血性心电图ST-T改变为主,异常发生率为61.4%,其次为心律失常,异常发生率为49.4%,且患者可并发1项、2项或其它多项心电图异常;各组患者间病情严重程度、梗死灶大小及预后比较,差异均有统计学意义(P<0.05)。结论:缺血性ST-T改变在老年急性缺血性脑梗死的病情严重程度及预后判断中具有重要临床应用价值,可用于指导患者治疗。

Objective ： To investigate the relationship between disease severity and ischemic ST - T change of dynamic electrocardiogram （ecg） characteristics in the elderly patients with acute ischemic infarction, and provide the theoretical basis for the diagnosis and prognosis. Methods： 83 cases of elderly patients with acute iscbemic cerebral iafarction undergoing ST - T change from January 2013 to December 2015 were screened out. All patients underwent cranial CT and conventional electrocardiogram （ECG）. According to the results of electrocardiogram examination, the pa- tients were divided into continuous ischemic ST - T group （ 16 cases）, transient ischemic ST - T group （44 cases） and non - ischemic ST - T group （23 cases）. The electrocardiographic features under dynamic changes of ST - T were analyzed, and the relationship between the infarct size and prognosis and incidences of ECG abnormalities in severe, moderate and mild cases were compared respectively. Results ： The main characteris- tic of ECG changes in this group of patients was ischemic myocardial electrocardiogram ST -T changes, with the incidence of abnormality at 61.4 %, followed by arrhythmia, with the incidence of abnormalities at 49.4 %. The patient can be complicated by 1,2 or a number of other ECG ab- normalities ; the severity of illness, infarct size and prognosis in each group were significantly different （ P 〈 0.05 ）. Conclusion ： Characteristics of ischemic ST - T changes have important clinical value in judging the severity and prognosis of elderly patients with acute ischemic infarction. It can be used to guide the treatment of patients.