急性脑梗死患者心电图异常的相关因素分析  

The risk factors of electrocardiographic abnormality in patients with acute Cerebral infarction

作　　者：刘建祥[1] 李兴明[1] 谷玉平 林盛[1] 王定佑[1] 朱飞奇[1] 

机构地区：[1]韶关市粤北人民医院,广东省韶关512000

出　　处：《中国医师杂志》2013年第5期626-628,共3页Journal of Chinese Physician

摘　　要：目的观察分析急性脑梗死患者心电图异常的相关危险因素。方法收集符合条件的急性脑梗死患者（189例）的临床资料[神经功能缺损评分（NIHSS评分）、心电图检查、血脂、血糖、糖化血红蛋白、BMI、同型半胱氨酸、超敏C反应蛋白、空腹血糖、白细胞总数、既往相关病史]，采用Logistics回归分析，查找与急性脑梗死患者心电图异常相关的因素。结果189例急性脑梗死患者心电图正常83例，异常106例，异常率56．09％；心电图异常以ST-T改变最为多见。经过单因素Lo-gistics回归分析，NIHSS评分（t=5．636，P〈0．01）、收缩压（t=2．617，P〈0．05）、总胆固醇（t=2．066，P〈0．05）、血白细胞总数（t=3．034，P〈0．01）等与急性脑梗死患者心电图异常有关；但多因素Logistics回归分析发现仅NIHSS评分、收缩压、血白细胞总数与心电图异常有关（r=1．18，P〈0．01；r=1．02，P〈0．01；r=1．19，P〈0．05）。结论脑梗死急性期神经功能缺损评分、收缩压及白细胞总数是心电图异常的危险因素，临床上对神经功能缺损评分较高，白细胞总数增加，收缩压较高的患者应加强心电图的监测，以防心脏并发症导致的病情加重。Objective To evaluate the risk factors of electrocardiographic abnormality in patients with acute cerebral infarction. Methods The clinical data of patients with acute cerebral infarction were collected, including the National Institutes of Health Stroke Scale （ NIHSS）, electrocardiogram （ ECG）, lipid, glucose, glycosylated hemoglobin, body mass index, homocysteine, high-sensitivity C-reactive pro- tein, white blood ceils, and medical history. Logistics regression was used to search the risk factors of ECG abnormality in patient with acute cerebral infarction. Results ECGs of 189 cases of patients with acute cer- ebral infarction were divided into normal （ n = 83） and abnormal （ n = 106）. The rate of abnormal ECG was 56. 09%, and abnormal ECG ST-T change was the most common. NIHSS, systolic blood pressure, total cholesterol, and white blood ceils were correlated with the ECG abnormality with the one-way Logistic re- gression analysis. In addition, N1HSS, systolic blood pressure, and white blood ceils were correlated with the ECG abnormality with the multiple Logistic regression analysis （ r = 1.18, P 〈0. 01 ; r = 1.02, P 〈 0. 01 ; r = 1.19, P 〈 0. 05）. Conclusions NIHSS, systolic blood pressure, and white blood cells were in- dependent risk factors in patients with acute cerebral infarction. ECG monitoring should be performed espe- cially in patients with high NIHSS, systolic blood pressure, and white blood cells count.

关 键 词：脑梗死 心电描记术 危险因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]