急性脑卒中Tp-e及Q-TC间期的变化及其临床意义  

Changes of Tpeak-Tend and QT Interval in electrocardiogram of patients with acute stroke and its clinical significance

作　　者：孙华群[1] 

机构地区：[1]浙江省人民医院心电图室,杭州310014

出　　处：《浙江医学》2012年第20期1638-1639,1643,共3页Zhejiang Medical Journal

摘　　要：目的探讨急性脑卒中患者T波峰末间期（Tp—e）及Q—Tc间期变化及其临床意义。方法选择急性脑卒中患者147例，按脑卒中类型分为脑梗死组（98例）、脑出血组（49例），同时选择65例无脑卒中患者作为对照组。比较各组的Tp—e、Tp—ec、Q—Tc间期。结果Tp—e、Tp—ec、Q—Tc间期脑出血组为（115．51±19．03）、（133．31±2691）、（418．82±44．60）ms，脑梗死组为（110．28±15．08）、（123．38±21．32）、（41785±24．93）ms，显著大于对照组（103．94±15．06）、（112．71±1690）、（398．23±4798）ms，差异有统计学意义（P〈0．05或0．01）；脑出血组与脑梗死组比较Tp—e间期、Q—Tc间期略延长，差异无统计学意义（P〉0．05），Tp—e。间期明显延长，差异有统计学意义（P〈0．01）。右侧脑梗死者Tp—e、Tp—ec、Q—Tc间期为（109．30±16．88）、（12445±2284）、（417.43±27．11]ms．较左侧脑梗死者[（107．04±1332）、（117．11±19．23）、（412．99±29．47）]略延长，差异均无统计学意义（均P〉0．05）。结论脑卒中急性期Tp—e、Tp—ec、Q—T。间期明显延长，易发生恶性室性心律失常，脑卒中急性期应加强心电图监测。Objective To investigate the changes of Tpeak-end interval （Tp-e） and corrected Q-T interval （Q-Tc） in electrocardiogram （ECG） of patients with acute stroke. Methods One hundred and forty seven patients with acute stroke, including 49 cases with cerebral hemorrhage and 98 cases with cerebral infarction, were enrolled in the study; 65 age-matched subjects free of acute stroke served as controls. Simultaneous 12-lead electrocardiograms （ECGs） were recorded within the first 24h from stroke onset. Tp-e,Tp-ec and Q-Tc were assessed both manually and automatically by assessors blinded to the clinical data. Tp-e,Tp-ec and Q-Tc were compared between different groups. Results Tp-e,Tp-ec and Q-Tc were significantly greater in cerebral hemorrhage group （115.51 ± 19.03ms,133.31 ± 26.91ms, 418.82 ± 44.60ms） and cerebral infarction group （ 110.28 ± 15.08ms, 123.38 ±21.32 ms, 417.85 ±24.93ms）than those in control group （103.94 ± 15.06ms, 112.71 ± 16.90ms, 398.23 ± 47.98ms） （P〈0.05 or 0.01 ）.Tp-ec was significantly greater in cerebral hemorrhage group than that in cerebral infarction group（P〈 0.01）,Tp-e and Q-Tc were longer in cerebral hemorrhage group than cerebral infarction group, but the difference was no significant （P 〉0.05）. Tp-e,Tp-ec and Q-Tc were longer in the right cerebral infarction group than the left cerebral infarction group, but the difference was no significant （P 〉0.05）. Conclusion The incidence of malignant ventricular arrhythmia may increase with prolonged Tp-e,Tp-ecor Q-Tc in patients with acute stroke. Electrocardiogram should be monitored in patients with acute stroke.

关 键 词：急性脑卒中 T波峰末间期 Q-TC间期 跨室壁复极离散度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]