心电图在急性脑梗死与脑出血临床检测与预后分析中的应用

Application of ECG in clinical detection and prognosis analysis on patients with acute cerebral infarction and cerebral hemorrhage

目的探讨心电图在急性脑梗死与脑出血临床检测与预后分析中的应用。方法对我院收治的105例患有急性脑梗死和脑出血的急性脑血管疾病患者的临床资料进行回顾性分析,所有患者经磁共振成像和头颅CT确诊,并同心电图检查结果进行对比分析。结果 105例患者中出现心电图异常者69例,异常率为65.7%。其中,急性脑梗死患者57例,心电图异常36例(63.2%);脑出血患者48例,心电图异常33例(68.8%)。患者的心电图异常主要表现为T波改变、ST-T改变、心律失常、QT间期延长、明显U波、异常Q波等,且与病变部位有关。丘脑发生病变的患者心电图异常率明显高于其他部位发生病变的患者。在36例心电图正常患者中,死亡2例(5.6%);在69例心电图异常患者中,死亡9例(13.0%),差异有统计学意义(P<0.05)。无意识障碍患者68例,心电图异常33例(48.5%);存在意识障碍患者37例,心电图异常31例(83.8%),差异也有统计学意义(P<0.05)。结论急性脑梗死和脑出血患者具有较高的心电图异常率,并且异常类型较多。心电图变化可作为初步判断病情和预后的指标。

Objective To investigate the application of electrocardiogram (ECG) in clinical detection and prognosis analysis on patients with acute cerebral infarction and cerebral hemorrhage.Methods Retrospective analysis was performed on clinical data of 105 cases with cerebrovascular diseases, acute cerebral infarction and cerebral hemorrhage, who had been admitted in our hospital.All the enrolled patients were diagnosed by magnetic resonance imaging (MRI) and cranial computer tomography(CT) . Comparative analysis was made among the results of MRI, CT and ECG. Results Among the 105 cases, there were 69 with ECG abnormalities, and the rate was 65. 7% . Specifically,ECG abnormalities were found in 36(63. 2% ) out of 57 cases with acute cerebral infarction and in 33 (68. 8% ) out of 48 cases with cerebral hemorrhage. ECG abnormalities were mainly arrhythmia, QT interval prolongation, ST-T changes, obvious U wave, abnormal Q wave, T wave changes and so on. The rate of ECG abnormalities was related to diseased regions. The rate of patients with thalamic lesions was significantly higher than that of patients with other diseased regions.Among 36 cases with normal ECG, 2(5. 6% ) died while among 69 cases with abnormal ECG,9(13.0% ) died. The difference was statistically significant(P <0. 05) . The rate of ECG abnormalities was 48. 5 % (33/68) among 68 patients without disturbance of consciousness while the rate was 83. 8% (31/37) among 37 patients with disturbance of consciousness. The difference was also statistically significant(P < 0. 05 ) . Conclusion The rate of ECG abnormalities is relatively high in patients with acute cerebral infarction and cerebral hemorrhage, and the types of abnormalities are various. ECG changes can preliminarily serve as evaluation indicators of severity and prognosis.