急性岛叶梗死患者心电图与心肌标志物的变化  被引量:1

Changes of the electrocardiograms and the cardiac markers in patients with acute insular infarction

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作  者:臧召霞[1] 刘志强[2] 朴钟源[1] 刘永丹[1] 魏亚芬[1] 

机构地区:[1]黑龙江省医院香坊总院神经内一科,哈尔滨150036 [2]吉林大学白求恩医学院第一临床医院在读博士,长春150001

出  处:《中国医师进修杂志》2013年第7期30-33,共4页Chinese Journal of Postgraduates of Medicine

摘  要:目的探讨急性岛叶梗死患者心电图(ECG)与心肌标志物的变化及其与预后的关系。方法选择202例急性大脑中动脉供血区的非腔隙性脑梗死患者(病例组),其中岛叶梗死组136例,非岛叶梗死组66例,左侧岛叶梗死71例,右侧岛叶梗死65例。选择同期150例年龄匹配的非脑血管病并排除心脏病患者(对照组),检测心电图及血浆心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB),分析比较不同部位大脑半球脑梗死患者的心电图和血浆cTnI、CK.MB的变化,并随访6个月的死亡情况。结果病例组患者心电图异常发生率及血浆eTnI、CK.MB升高率与对照组比较差异有统计学意义(P〈0.01)。岛叶梗死组患者心电图异常发生率为80.88%(110/136),明显高于非岛叶梗死组的46.97%(31,66)(P〈0。05),病死率[11.76%(16/136)]亦明显高于非岛叶梗死组[3.03%(2/66)](P〈0.01);右侧岛叶梗死患者异位搏动和QT间期延长发生率明显高于左侧岛叶梗死患者[44.62%(29/65)比11.27%(8,71),P〈0.01;55.38%(36/65)比35.21%(25/71),P〈0.05],左侧岛叶梗死患者窦性心动过缓、ST段异常发生率明显高于右侧岛叶梗死患者[22.54%(16/71)比7.69%(5,65),P〈0.05;47.89%(34,71)比13.85%(9/65),P〈0.05]。血浆cTnI、CK.MB升高主要见于岛叶梗死患者[岛叶梗死组发生率分别为47.79%(65/136)、34.56%(47/136),非岛叶梗死组分别为4.55%(3/66)、1.52%(1/66),P〈0.01],右侧岛叶梗死患者血浆cTnI升高发生率[67.69%(44/65)]高于左侧[29.58%(21/71)](P〈0.05),左、右侧岛叶梗死患者血浆CK.MB升高发生率比较差异无统计学意义(P〉0.05);血浆cTnI、CK.MB升高患者病死率明显高于血浆cTnI、CK—MB正常患者[16.18�Objective To investigate the changes of the electrocardiograms (ECG) and the cardiac markers in patients with acute insular infarction, and analyze the relationship between them and the prognosis. Methods A total of 202 patients with acute middle cerebral artery territory infarction (patients group) and 150 control subjects (control group) was selected in this study. Patients included insular infarction (insular infarction group, 136 cases), non-insular infarction (non-insular infarction group, 66 cases) ,left-side insular infarction(71 cases) and right-side insular infarction(65 cases). ECG recordings and plasma cardiac troponin I (cTnI), creatine kinase-MB (CK-MB) were measured and compared. Death in 6 months was followed-up. Results There was significant difference in the incidence of abnormal changes of ECG and plasma cTnI, CK-MB increasing between patients group and control group (P 〈 0.01 ). The incidence of abnormal changes of ECG and fatality rate were higher in insular infarction group than those in non-insular infarction group [80.88% (110/136) vs. 46.97% (31/66) and 11.76% (16/136) vs. 3.03% (2/66),P 〈 0.05 or 〈 0.01 ]. The incidences of ectopy and prolonged QT were higher in right-side insular infarction patients than those in left-side insular infarction patients [ 44.62%(29/65 ) vs. 11.27% (8/71 ), P 〈 0.01;55.38% (36/65) vs. 35.21% (25/71), P 〈 0.05 ]. The incidences of sinus bradycardia and ST segment deviation were higher in left-side insular infarction patients than those in right-side insular infarction patients [22.54%( 16/71 ) vs. 7.69%(5/65 ) ,P 〈 0.05 ;47.89%(34/71 ) vs. 13.85%(9/65) ,P 〈 0.05 ]. The increased rates plasma cTnI and CK-MB level were mainly seen in insular infarction [insular infarction group: 47.79% (65/136), 34.56% (47/136); non-insular infarction group: 4.55% (3/66), 1.52% (1/66) ,P 〈 0.01 ]. The incidence of plasma cTnI increasing in right-side insul

关 键 词:脑梗塞 心电描记术 心肌标志物 

分 类 号:R542.22[医药卫生—心血管疾病]

 

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