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迄今为止,大量证据表明卒中可引起心脏相关(心脏超声、心电图、心肌酶等)改变。心电图异常表现为ST段改变及各种类型的快速型心律失常(尤其是房颤)和心动过缓。而心律失常是急性卒中病人的主要致死原因,因此对病人进行仔细、持续的心电监护以确定心律失常类型非常重要。另外氨基末端脑钠肽前体(NTpro BNP)可用于评估院内及远期心律失常和死亡发生率,而高水平BNP可能提示较差的临床预后。已有证据表明急性卒中可致心脏收缩功能障碍,而后者是住院期间死亡的高危因素。另有研究表明心脏舒张功能障碍也可出现于急性卒中,此时交感神经兴奋导致可逆性心肌损害及心肌酶增高可能是其主要原因。作者从上述几点总结分析卒中后心脏相关改变特点,为临床提供一定依据。
To date, there is ample evidence that stroke can cause changes in the heart (echocardiography, electrocardiogram, myocardial enzymes, etc.). ECG abnormalities showed changes in ST segment and various types of tachyarrhythmia (especially atrial fibrillation) and bradycardia. Arrhythmias are the leading cause of death in acute stroke patients, so it is important that patients be carefully and continuously monitored to determine the type of arrhythmia. In addition, N-terminal pro-brain natriuretic peptide (NTpro BNP) can be used to assess the incidence of arrhythmias and death in the hospital and in the future, while high BNP levels may suggest poor clinical outcomes. There is evidence that acute stroke can cause systolic dysfunction, which is a risk factor for death during hospitalization. Other studies have shown that diastolic dysfunction can also occur in acute stroke, when sympathetic activation leads to reversible myocardial damage and increased myocardial enzymes may be the main reason. From the above summary of the above-mentioned analysis of changes in heart-related characteristics of stroke after stroke, provide a basis for clinical.