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目的探讨急性脑血管病与心电图异常的关系。方法回顾性分析2008年1月至2010年12月期间急性脑血管病300例,其中脑梗死(包括腔隙性脑梗死)125例,脑出血89例(其中14例脑出血合并脑梗死),珠网膜下腔出血81例,动脉瘤5例,所有患者诊断均有CT证实。结果心电图异常266例占87.7%,有些患者心电图异常同时存在二种以上占54%,心电图异常发生率较高有:ST段降低,T波低平、双向、倒置,Q-T间期延长,窦性心动过缓。有些重症患者可见严重心律失常和心肌梗死发生。结论急性脑血管病发生后,脑实质特定部位损害,当杏仁核损害时,心电图出现异常改变,脑干首端受损可引起反射性冠状动脉供血不足,当额叶眶面13区,24区受损时,可引起心肌功能紊乱,当血液进入脑室及病灶位于脑深部或病变影响脑干时,心电图常有明显改变,同时颅内压增高,血肿对周围组织的压迫引起脑组织移位,造成支配心脏的中枢神经功能异常,导致植物神经的功能失调,出现心电图的紊乱现象,总之心电图异常改变原因较多,对重症的脑血管患者要进行心电图监护注意与原发心脏疾患加以区别。
Objective To investigate the relationship between acute cerebrovascular disease and abnormal ECG. Methods A retrospective analysis of 300 cases of acute cerebrovascular disease between January 2008 and December 2010 included 125 cases of cerebral infarction (including lacunar infarction), 89 cases of intracerebral hemorrhage (including 14 cases of cerebral hemorrhage complicated by cerebral infarction) 81 cases of sub-subhepatic hemorrhage, aneurysm in 5 cases, all patients diagnosed by CT confirmed. The results of 266 cases of abnormal electrocardiogram accounted for 87.7%, some patients with ECG abnormalities exist at the same time more than two accounted for 54%, higher incidence of abnormal electrocardiogram: ST segment depression, T wave low level, bidirectional, inverted, QT interval prolongation, sinus Bradycardia. Some critically ill patients showed severe arrhythmia and myocardial infarction. Conclusions After acute cerebrovascular disease, certain parts of brain parenchyma damage, when the amygdala damage, abnormal ECG changes, brain stem damage can cause reflex coronary insufficiency, when the frontal orbital area 13, 24 Impaired, can cause myocardial dysfunction, when the blood into the ventricle and lesions located in the deep brain lesions or affect the brain stem, ECG often obvious changes, while increased intracranial pressure, hematoma on the surrounding tissue caused by brain tissue shift oppression, Resulting in dysfunction of the central nervous system that controls the heart, leading to dysfunction of the autonomic nervous system, resulting in the phenomenon of electrocardiogram disorder. In short, there are many reasons for the abnormal changes of the electrocardiogram. The patients with severe cerebrovascular disease should be distinguished from the primary heart disease by ECG monitoring.