急性脑卒中患者心脏电学改变研究  

Study on the electrical changes of the heart in patients with acute stroke

作　　者：井艳[1] 张芳芳[1] 申继红[1] 黄菊香[1] 闫琼文 周雨菡 聂连涛 李中健[1] 李世锋[1] JING Yan;ZHANG Fangfang;SHEN Jihong;HUANG Juxiang;YAN Qiongwen;ZHOU Yuhan;NIE Liantao;LI Zhongjian;LI Shifeng(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2024年第6期737-741,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20210392)。

摘　　要：目的通过分析急性脑卒中患者心脏电学变化,探讨心电图评估急性脑卒中患者血压控制效果的临床价值。方法选取2023-06—2024-01郑州大学第二附属医院收治入院的急性脑卒中患者103例(脑出血50例,脑梗死53例)为研究组,原发性高血压患者61例为对照组,分析研究组临床资料和心电图特点,比较研究组和对照组的心电图改变。将研究组分为血压异常组和血压正常组,比较不同血压状态下脑出血和脑梗死患者心电图改变。结果急性脑卒中患者中脑出血患者年龄偏小,糖尿病占比高,入院收缩压/舒张压、血糖较高,差异有统计学意义(P<0.05)。脑卒中患者心电图异常率高于原发性高血压患者,以P波时限≥120 ms、P波双峰(峰间距>40 ms)、Macrua指数、左心室高电压、左心室肥大、快速性心律失常检出率较高,差异有统计学意义(P<0.05)。脑出血患者心电图异常率高于脑梗死患者,左心房/左心室肥大、心肌缺血比较差异有统计学意义(P<0.05)。血压异常的脑出血患者心电图异常率高于血压正常者,左心房/左心室肥大、心肌缺血比较差异有统计学意义(P<0.05)。血压异常的脑梗死患者快速性心律失常检出率高于血压正常者,差异有统计学意义(P<0.05)。结论急性脑卒中患者心电图异常率高,尤其高血压合并脑卒中患者心电图异常表现更加明显,心电图检查可作为诊断和评估急性脑卒中患者血压控制效果的重要依据。Objective To investigate the clinical value of electrocardiogram examination in evaluating the effectiveness of blood pressure control in patients with acute stroke by analyzing the cardiac electrical changes in patients with acute stroke.Methods Totally 103 acute stroke patients(50 with cerebral hemorrhage and 53 with cerebral infarction)admitted to the Second Affiliated Hospital of Zhengzhou University from June 2023 to January 2024 were selected as the study group,and 61 patients with primary hypertension were selected as the control group.Clinical data and electrocardiogram characteristics of the study group were analyzed,and the the differences in electrocardiogram changes between the study group and the control group was compared.The study group were divided into abnormal blood pressure group and normal blood pressure group,and the differences in electrocardiogram changes between patients with cerebral hemorrhage and cerebral infarction under different blood pressure states were compared.Results Among stroke patients,patients with cerebral hemorrhage were younger,the proportion of diabetes was higher,and the systolic/diastolic blood pressure and blood sugar at admission were higher,the difference was statistically significant(P<0.05).The abnormal detection rate of electrocardiograms in stroke patients was higher than that in primary hypertension patients.The detection rates of P-wave time limit≥120 ms,P-wave bimodal(peak spacing>40 ms),Macrua index,left ventricular high voltage,left ventricular hypertrophy,and rapid arrhythmia were higher,and the differences were statistically significant(P<0.05).The abnormal rate of electrocardiogram in patients with cerebral hemorrhage was higher than that in patients with cerebral infarction,and there was a statistically significant difference in left atrial/left ventricular hypertrophy and myocardial ischemia(P<0.05).The abnormal rate of electrocardiogram in patients with cerebral hemorrhage with abnormal blood pressure was higher than that in those with normal blood

关 键 词：急性脑卒中 脑出血 脑梗死 血压 心脏电学 左房室肥大 心肌缺血 心律失常 

分 类 号：R743.3[医药卫生—神经病学与精神病学]