急性脑梗死患者心电图改变及其对预后的临床意义研究  

Frequency and Prognostic Significance of Electrocardiographic Changes in Patients with Acute Ischemic Stroke

作　　者：李路军[1] 曹江晨[2] 曹宏兵[3] 周红霞[3] 杨善进[3] 范利娟[3] 

机构地区：[1]南京军区联勤部无锡干休所 [2]中国人民解放军73801部队门诊部 [3]中国人民解放军第359医院内科

出　　处：《中国全科医学》2011年第11期1202-1204,共3页Chinese General Practice

摘　　要：目的调查既往心电图正常者在脑梗死后心电图异常的发生率及其对脑梗死患者预后的临床意义。方法收集10年间168例既往无心脏疾病者在发生急性脑梗死后心电图变化及其1个月的随访资料,完成统计分析。结果 168例患者心电图异常发生率是64.9%(109/168)。最常见的心电图异常是心肌缺血,包括ST段压低和抬高、异常T波和异常U波。脑梗死后早期死亡率是25.7%(28例)。额叶梗死患者异常T波和异常U波的发生率高于其他梗死部位,差异有统计学意义(P<0.05)。单变量分析提示年龄、ST段改变和异常U波是早期死亡的预测因子;而多变量分析提示年龄>65岁和ST段改变是死亡的独立预测因子。结论平时心电图无异常者在发生急性脑梗死后发生各种心电图改变很常见,其中年龄>65岁、ST段改变是早期死亡的独立预测因子,心电图改变对平时心电图正常的脑梗死患者的预后有重要的预测价值。Objective To investigates the frequency and prognostic significance of electrocardiographic（ECG） changes in patients with ischemic stroke but without primary heart disease.Methods Totally 168 patients（95 men;aged 64.1±13.9 years） with acute stroke were observed for ECG changes during their stay in hospital and their clinical information were obtained during the 4-week follow-up.Results Of these 168 patients,109（64.9%） experienced ECG changes,which were most commonly associated with myocardial ischemia,including depressed/elevated ST segment and abnormal T/U waves.The one-month mortality rate in the patients with ECG changes was 19.0%.Univariate analysis showed age,ST-segment,and abnormal U wave independent predictors of early mortality,and multivariate analysis showed an age 65 years and the presence of ST-segment change were independent predictors.Conclusion ECG changes are common in patients with ischemic stroke,even though they may have no previous history of ECG abnormality.An age 65 years and the presence of ST-segment change were independent predictors of early mortality.ECG changes are highly predictive for the prognosis.

关 键 词：脑梗死 心电描记术 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]