缺血性脑卒中高危因素贝叶综合征的心电图表现及其与缺血性脑卒中其他危险因素的相关性  

A high risk factor of acute ischemic stroke-Bayes syndrome:ECG manifestation and its correlation with other risk factors of acute ischemic stroke

作　　者：刘红平[1] 方方 唐海桃 陈松涛[1] LIU Hong-Ping;FANG Fang;TANG Hai-Tao;CHEN Song-Tao(ECG Room,Department of Ultrasound Medicine,Jiuquan People′s Hospital,Jiuquan 735000,Gansu Province,China;Department of Cardiology,North-Beijing Medical Branch,Chinese PLA General Hospital,Beijing 100085,China)

机构地区：[1]甘肃省酒泉市人民医院超声医学科心电图室,甘肃酒泉735000 [2]中国人民解放军总医院京北医疗区心血管内科,北京100085

出　　处：《中华老年多器官疾病杂志》2021年第7期518-522,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨急性缺血性脑卒中(AIS)新危险预警指标——贝叶综合征(Bayes综合征)的心电图表现及其与AIS其他危险因素的相关性。方法选择2018年10月至2019年6月甘肃省酒泉市人民医院收治的心电图为窦性心律的195例AIS患者为研究对象,其中心源性栓塞性卒中患者80例(栓塞性卒中组),非栓塞性卒中患者115例(非栓塞性卒中组),比较2组患者一般资料、AIS相关危险因素、美国国立卫生研究院卒中量表(NIHSS)评分及房间阻滞综合征(IAB)的发生情况。将存在IAB的98例患者分为不完全IAB(pIAB)组和高度IAB(aIAB)组,比较2组患者阵发性心房颤动(简称房颤)史、左心房内径及心源性栓塞性卒中发生情况。采用SPSS 22.0统计软件进行数据分析。根据数据类型分别采用t检验或χ^(2)检验。危险因素的判断采用多因素logistic回归分析。结果栓塞性卒中组中53例(66.2%)患者常规心电图存在IAB,IAB和已知的心源性卒中危险因素高血压、阵发性房颤史、左心房扩大在2组中差异均有统计学意义(均P<0.05);2组NIHSSP评分比较,差异有统计学意义(P<0.05),栓塞性卒中组卒中程度重。阵发性房颤史、左心房扩大、心源性栓塞性卒中在aIAB中有较高的检出率(均P<0.05)。结论Bayes综合征的心电图表现是AIS(尤其心源性栓塞性卒中)的新危险预测因素,心电图表现为aIAB时更有利于预测心源性栓塞性卒中的发生及提高左心房扩大、房颤等危险因素的检出率。因此,重视Bayes综合征的心电图表现对提高脑卒中筛查与防治效果有重要的临床意义。Objective To investigate the ECG manifestation of Bayes syndrome,a new early risk warning indicator of acute ischemic stroke(AIS),and its correlation with other risk factors of AIS.Methods A total of 195 AIS patients with sinus rhythm by electrocardiography(ECG)admitted to Jiuquan People′s Hospital from October 2018 to June 2019 were enrolled in this study,including 80 patients in cardiogenic embolic stroke group and 115 patients in non-embolic stroke group.The general information,AIS-related risk factors,National Institutes of Health stroke scale(NIHSS)score,and interatrial block(IAB)differences were compared between the two groups.Ninety-eight patients with IAB were further assigned into partial IAB(pIAB)and advanced IAB(aIAB)subgroups,and history of paroxysmal atrial fibrillation,left atrial diameter,and incidence of cardiogenic embolic stroke were analyzed between the two subgroups.SPSS statistics 22.0 was used to perform the statistical analysis.Student′s t test or Chi-square test was employed for different data types.Multivariate logistic regression analysis was adopted to analyze the influencing factors of cardioembolic stroke.Results In the embolic stroke group,53 patients(66.2%)had IAB on routine ECG,and IAB was significantly different between the two groups(P<0.05),as were known risk factors for cardiogenic stroke,hypertension,paroxysmal atrial fibrillation,left atrial enlargement.There was statistical difference in NIHSS score between the two groups(P<0.05),and the embolic stroke group experienced severer stroke.History of paroxysmal atrial fibrillation,left atrial enlargement,and cardiogenic embolic stroke were more common in the aIAB subgroup(P<0.05).Conclusion The ECG manifestation of Bayes syndrome is a new risk predictor for AIS,especially for cardiogenic embolic stroke.The manifestation of aIAB on electrocardiogram is more conducive to predict the occurrence of cardiogenic embolic stroke and improve the detection rate of risk factors such as left atrial enlargement and atrial fibrillation.So,

关 键 词：缺血性卒中 贝叶综合征 危险因素 相关性研究 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R540.41[医药卫生—临床医学]