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目的分析急性脑血管病的心电图改变特点并探讨可能的发生机制。方法对387例急性脑血管病患者发病24h内行颅脑CT、标准导联ECG及心肌酶学检查。结果387例患者ECG的异常率为91.7%(355/387)。珠网膜下腔出血100%(31/31),脑出血94·3%(99/105),脑梗死89.6%(225/251)。心律失常的发生率以窦性心动过速最常见,其他依次为窦性心动过缓、室性早搏、房性早搏,室内束支传导阻滞及房颤。T波低平或倒置发生率最高,其他依次为ST段下移,ST段抬高、双峰T波、T波大而直立、U波增大、Q-T间期延长及出现J波。急性心肌梗塞发生率5%。结论急性脑血管病患者中ECG的异常发生率较高,与脑损伤部位有一定关系。临床上应给予足够的认识,以采取合理的治疗措施。
Objective To analyze the characteristics of electrocardiogram changes in acute cerebrovascular disease and to explore the possible mechanism. Methods 387 patients with acute cerebrovascular disease within 24 hours of onset of brain CT, standard lead ECG and myocardial enzymology. Results The abnormal rate of ECG in 387 patients was 91.7% (355/387). Subthalamic hemorrhage 100% (31/31), cerebral hemorrhage 94.3% (99/105), cerebral infarction 89.6% (225/251). The incidence of arrhythmia to sinus tachycardia is the most common, followed by sinus bradycardia, premature ventricular contractions, atrial premature beats, bundle branch block and atrial fibrillation. The incidence of T wave was the lowest or the inversion was the highest. The others were ST-segment elevation, ST-segment elevation, Bimodal T wave, T wave large and erect, U wave increased, Q-T interval prolonged and J wave appeared. The incidence of acute myocardial infarction 5%. Conclusion The incidence of ECG abnormalities in patients with acute cerebrovascular disease is high, and it has some relationship with the brain injury site. Clinical knowledge should be given sufficient to take reasonable treatment.