脑卒中ECG改变临床意义的探讨  

Clinical Significance on Abnormal Electrocardiogram of Patients with Cerebral Apoplexy

作　　者：王雅纯[1] 

机构地区：[1]广东省汕头大学医学院第二附属医院心电图室,广东汕头515041

出　　处：《华西医学》2003年第2期207-209,共3页West China Medical Journal

摘　　要：目的 :探讨脑卒中伴随的ECG改变与脑卒中的关系和临床意义。方法 :对我院 1 0 0例脑卒中、 1 0 0例慢性胃肠病和 1 0 0例健康人的ECG检查结果进行对照分析。结果 :①脑卒中组中检出的 2 3项异常ECG指标中 ,与非脑卒中组和正常人组相比 ,1 1项有显著差异 ;② 2 0例无异常ECG的脑卒中病例 ,无 1例病情恶化和死亡 ;80例有异常ECG的脑卒中病例 ,2 5例病情恶化和死亡 ,两者差异显著 (X2 =5 932 ;P <0 0 5 ) ;③ECG呈良性转归与ECG呈不良转归的病例相比 ,病情的预后显著不同 (X2 =1 9 35 8,P <0 0 0 5 ) ;④正常ECG病例随意识障碍的加重而减少 ,不正常ECG病例随意识障碍的加重而增多 ,相关关系显著 (X2 =2 3 89,P <0 0 0 5 ) ;ECG呈良性转归的病例主要集中在Hunt-Hessscale分级的 1～ 2级中 ,而ECG呈不良转归的病例主要集中在 4～ 5级中 ,相关关系显著 (X2 =1 1 97,P <0 0 0 5 )。结论 :本研究显示脑卒中伴随的ECG改变确实可由脑卒中引起。ECG检查及动态监测可作为脑卒中病情轻重和预后判断的一个重要手段 ,并能及时发现脑卒中患者的心脏问题 ,以尽早进行临床干预 。Objective:To investigate the relationship between electrocardiogram(ECG)changes accompanying the patients with cerebral apoplexy(CA)and CA and its clinical significance Methods:The results of ECG from 100 cases with CA,100 chronic gastrointestinal disease(CGID)and 100 healthy persons(HP)were analysed comparatively.Results:①11 of 23 abnormal ECG targets detested in 100 patients with CA indicated significant difference comparie with CGID and HP.②exacerbation and death did not appear in any one of 20 CAs with normal ECG,but appeared in 25 of 80 CAs with abnormal ECG(X 2=5 932, P <0 05).③Prognosis of CA with both benign transform and malignant transform of abnormal ECG was of significant difference(X 2=19 358, P <0 005).④The number of CA with normal ECG decreased as disturbance of consciousness worsened,while with abnormal ECG increased(X 2=23 89, P <0 005) CA cases of benign transform of abnormal ECG concentrated mainly on grade 1～2 of Hunt-Hess scale of disturbance of consciousness,while malignant transform did grade 4～5(X 2=11 97, P <0 005) Conclusions:The study showed that the ECG changes accompanying CA is really caused by the CA itself.ECG examination and its continuous monitoring may be used as an important methods in assessing state and prognosis of CA and,moreover,can find the heart trouble of CA promptly in order to carry on positive intervention and protect the cardiac function.

关 键 词：脑卒中 ECG 心电描记术 预后 动态监测 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]