心电图非特异性ST-T异常与急性缺血性脑卒中复发的相关性  

Correlation between nonspecific ST-T abnormalities in electrocardiogram and recurrence of acute ischemic stroke

作　　者：徐文灯 沈懿 张小峰 Xu Wendeng;Shen Yi;Zhang Xiaofeng(Department of Neurology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院神经内科、清华大学临床医学院,北京102218

出　　处：《临床荟萃》2023年第10期883-886,共4页Clinical Focus

摘　　要：目的心电图非特异性ST-T异常NSSTTAs常见于无症状人群,为缺血性脑卒中的危险因素。本研究旨在探索心电图非特异性ST-T异常对于急性缺血性脑卒中患者复发的相关性。方法本研究纳入北京清华长庚医院2016年12月-2017年8月急诊入院及2019年8月-2020年4月收入病房的急性缺血性脑卒中患者,对入组患者进行电话/门诊随访;以1年内缺血性脑卒中复发为终点指标;根据复发情况分为复发组和非复发组,分别对两组患者进行单因素及多因素分析明确NSSTTAs对于急性缺血性脑卒中复发的相关性。结果本研究共纳入197例患者,平均年龄(66.4±11.4)岁,女性54例(27.4%);根据是否在1年内复发,分为复发组及非复发组;其中,22例(11.2%)患者复发;78例(39.5%)存在NSSTTAs,复发组具有吸烟史的比例大于非复发组(72.7%vs 50.3%,P=0.047);复发组具有NSSTTAs的比例大于非复发组(63.6%vs 36.6%,P=0.014);矫正吸烟、高同型半胱氨酸血症、高脂血症后,NSSTTAS(OR=2.847,95%CI:1.110~7.305,P=0.030)为缺血性脑卒中患者复发的独立危险因素。结论NSSTTAs在急性缺血性脑卒中常见,可能是急性缺血性脑卒中复发的预测因子。Objective Non-specific ST-T abnormalities(NSSTTAs)in electrocardiogram are common in asymptomatic people,which are risk factors for ischemic stroke.This study aims to investigate the correlation between NSSTTAs in electrocardiogram and recurrence of acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to Department of Emergency,Beijing Tsinghua Changgung Hospital from December 2016 to August 2017 and hospitalized from August 2019 to April 2020 were included in this study,and the telephone/outpatient follow-up was performed.Recurrence of ischemic stroke within one year was the endpoint.According to the recurrence,patients were divided into recurrent group and non-recurrent group.Univariate and multivariate analyses were performed on the two groups to determine the correlation between NSSTTAs and recurrence of acute ischemic stroke.Results A total of 197 patients were included in this study,with the mean age of(66.4±11.4)years.Among them,27.4%(54/197)were female.They were divided into recurrent group and non-recurrent group according to the 1-year recurrence,involving 11.2%(22/197)relapsed patients and 39.5%(78/197)with NSSTTAs.The proportion of patients with a history of smoking in the recurrent group was significantly higher than that of the non-recurrent group(72.7%vs 50.3%,P=0.047)and that with NSSTTAs in the recurrent group was significantly higher than the non-recurrent group(63.6%vs 36.6%,P=0.014).NSSTTAs(OR=2.847,95%CI:1.110-7.305,P=0.030)were the independent risk factor for recurrent ischemic stroke patients after adjustmnet for smoking,hyperhomocysteinemia and hyperlipemia.Conclusion NSSTTAs are common in patients with acute ischemic stroke.Patients with acute ischemic stroke and NSSTTAs may have a higher risk of recurrence.

关 键 词：缺血性脑卒中 心电图 ST-T段 复发 

分 类 号：R743.3[医药卫生—神经病学与精神病学]