摘要
目的:分析脑卒中后脑心综合征(CCS)的临床特点,探讨其发病机制及防治措施。方法:回顾性分析2010年1月至2012年6月收治的210例急性脑卒中患者的心电图、心肌酶谱等资料。结果:210例急性脑卒中患者合并CCS者122例(58%),脑梗死组、脑出血组和蛛网膜下腔出血组中发生CCS者分别为47例(42.0%)、63例(76.8%)和12例(75.0%),其中心肌梗死患者分别为2、4、1例,出血性卒中发病率明显高于缺血性卒中(P<0.05)。122例急性脑卒中患者合并CCS患者中死亡25例(20.5%),88例无CCS患者中死亡9例(10.2%),两者比较,差异有统计学意义(P<0.05)。脑卒中后CCS患者的心电图中以ST-T延长最为常见。脑梗死组、蛛网膜下腔出血组患者CK、CK-MB、AST、LDH水平较脑出血组低(P<0.01)。结论:急性脑卒中患者易合并CCS,应加强心脏功能的监护,保护心脏功能,防止心源性猝死,提高患者生存率。
Objective：To analyze the clinical characteristics, pathogenesis and approaches for prevention and treatment of cerebrocardiac syndrome （CCS） following acute cerebral stroke. Methods： We retrospectively analyzed the profiles, including electrocardiogram and myocardial enzymes, in 210 patients with cerebral stroke who were admitted to Shenzhen Longgang Second People＇ s Hospital and Shenzhen Second People＇ s Hospital between January 2010 and June 2012. Results： Of 210 patients with c.erebral stroke, 122 （58%） had concomitant CSS. The incidence of CSS was 42.0% （n =47）, 76. 8% （n =63） and 75.0% （n = 12） in patients with cerebral infarction, hemorrhage and subarachnoid hemorrhage, of whom 2, 4 and a single case developed myocardial infarction. Compared with ischemic stroke, the hemorrhagic stroke was characterized by a higher incidence rate （P 〈 0.05）. A higher mortality was found in patients with concomitant CCS compared with those not （20.5% [25/1221 vs. 10.2% [9/881, P 〈0.05）. Prolonged ST-T segment in electrocardiogram was the most frequently noted in those with concomitant CCS. Compared with cerebral hemorrhage, patients with cerebral infarction and subarachnoid hemorrhage yielded lower levels of creatinine kinase, creatinine kinase-MB, aspartate transferrase and lactate dehydrogenase （ all P 〈 0.01 ）. Conclusion： CCS is not uncommon in patients with cerebral stroke. Intensive monitoring and protection of the cardiac function may entail prevention of sudden cardiac death and improvement in the survival.
出处
《广州医学院学报》
2013年第2期106-108,共3页
Academic Journal of Guangzhou Medical College
关键词
急性脑卒中
脑心综合征
心电图
心肌酶
acute cerebral stroke
cerebrocardiac syndrome
electrocardiogram
myocardial enzyme
