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目的探讨丘脑卒中后脑心综合征(BHS)的临床特点及发病机制。方法对1998-06-2004-03广东省江门市人民医院203例急性丘脑卒中,合并有BHS的130例患者的临床资料进行回顾分析。结果BHS的发生率为64.0%,其中136例出血性丘脑卒中,BHS发生率为71.3%;67例梗死性丘脑卒中,BHS发生率为49.2%。出血性丘脑卒中发生BHs明显高于梗死性丘脑卒中(P<0.05)。BHS的94.6%发生在12h至3d内。BHS心电图主要表现为非低钾性U波、类心肌梗死或缺血、各类型心律失常。心肌酶谱异常率为47.3%。BHS病死率为45.5%,明显高于无发生BHS丘脑卒中患者(16%)(P<0.05)。并且BHS随着病情的好转而好转。结论急性丘脑卒中,BHS发生率较高,尤以出血性丘脑卒中BHS发生率高。BHS与丘脑卒中有明显相关性。合并BHS丘脑卒中患者病死率增高。
Objective To investigate the clinical characteristics and pathogenesis of brain stem syndrome (BHS) after thalamic stroke. Methods A retrospective analysis was performed on the clinical data of 203 patients with acute thalamic stroke and BHS with BHS from June 1998 to March 2004 in Jiangmen People’s Hospital of Guangdong Province. Results The incidence of BHS was 64.0%, of which 136 cases had hemorrhagic thalamic stroke, the incidence of BHS was 71.3%. 67 cases had infarction of thalamic stroke, the incidence of BHS was 49.2%. BHs in hemorrhagic thalamic stroke were significantly higher than those in infarcted thalamic stroke (P <0.05). 94.6% of BHS occurred within 12h to 3d. BHS ECG mainly for non-hypokalemic U wave, myocardial infarction or ischemia, all types of arrhythmia. Myocardial abnormality rate was 47.3%. The mortality rate of BHS was 45.5%, significantly higher than that of patients without stroke (16%) (P <0.05). And BHS improved as the condition improved. Conclusions Acute hypothalamic stroke has a high incidence of BHS, especially in patients with hemorrhagic thalamic stroke. There is a clear correlation between BHS and thalamic stroke. Patients with BHS thalamic stroke increased mortality.