蛛网膜下腔出血早期心电图异常的多因素相关性研究  

Research on early ECG abnormality in SAH patients and its correlation with clinical factor

作　　者：钱忠心[1] 刘卫东[1] 毛青[1] 刘向阳[1] 彭毅华[1] 丁勇[1] 孙伟[1] 严志忠[1] 

机构地区：[1]上海市浦南医院神经外科,200125

出　　处：《临床神经外科杂志》2007年第3期111-114,共4页Journal of Clinical Neurosurgery

摘　　要：目的了解蛛网膜下腔出血（spontaneous subarachnoid hemorrhage,SAH）患者早期心电图（electrictrpcardiogram,ECG）异常的发生率,并对相关的临床因素进行研究。方法回顾性分析2001.1-2006.1本单位临床诊断SAH的127例患者的临床资料。统计早期出现ECG异常的发生率。针对不同年龄、有无高血压史、出血原因、出血量（Fisher分级）以及不同病情（Hunt＆Hess分级）与ECG改变的关系进行单因素检验及多因素回归分析。结果127例SAH患者中早期ECG异常的发生率为68.5%。在单因素分析中,不同年龄、不同出血原因ECG早期异常发生率之间有统计学差异（P〈0.05）,不同Fisher分级、不同Hunt＆Hess分级组间ECG早期异常发生率有显著的统计学差异（P〈0.001）。而是否有高血压史组间无统计学差异（P〉0.05）。经多因素回归分析发现,高Fisher分级以及高Hunt＆Hess分级为引起ECG早期异常的独立危险因素。结论SAH患者早期ECG异常有着较高的发生率。出血程度及病情严重程度显著影响ECG异常的发生。临床上对Fisher分级及Hunt＆Hess分级较高的患者应加强心脏等颅外器官的监护。Objective To investigate the rate of early electrictrpcardiogram （ECG） abnormality after subarachnoid hemorrhage（SAH） and the correlation between the morbidity and a series of clinical factors. Methods Clinical data of 127 cases with SAH from January 2001 to January 2006 were analyzed retrospectively. Rate of early ECG abnormality was calculated. Univariate analysis also with multivariate regression analysis on correlation between the morbidity and clinical factors such as age, history of hypertension, cause of bleeding, Fisher grade of SAH and Hunt＆Hess gade is done. Results The rate of early ECG abnormality is 68.5%. In univariate analysis, statistic difference exists between groups divided by variant age, cause of bleeding（ P 〈 0.05 ） whereas significant difference between groups divided by Hunt＆Hess grade and Fisher grade（ P 〈 0. 001 ） . There~ no statistic difference between groups with history of hypertension or not. Multivariate regression analysis shows that Hunt ＆ Hess grade and Fisher grade are independent predictors of early ECG abnormality. Conclusions The rate of early ECG abnormality in patients with SAH is high. Patients with high Fisher grade or Hunt＆Hess grade are likely to have high rate of ECG abnormality. Close monitoring and special care of extra cranial organs such as heart should be taken on those patients.

关 键 词：蛛网膜下腔出血 心电图 Fisher分级 HUNT & Hess分级 

分 类 号：R743.35[医药卫生—神经病学与精神病学]