论文部分内容阅读
目的通过分析脑功能损伤引发心律失常(Arrhythmia,AHM)的临床资料,进一步提高对脑功能损伤引发AHM的认识,减少病死率。方法326例脑功能损伤引发心律失常患者均于发病48h内行颅脑CT检查,来诊4d内行ECG或/和Holter检查,必要时行心电监护,跟踪复查。结果(1)脑出血性患者引发AHM的几率高于脑梗死性患者(P<0.05);(2)左侧基底核-丘脑及大脑皮质功能损伤引发的缓慢型AHM多于右侧(P<0.05),右侧基底核-丘脑及大脑皮质功能损伤引发的快速型AHM多于左侧(P<0.05)。结论(1)左侧大脑半球以支配副交感神经为主,右侧大脑半球以支配交感神经为主;(2)左侧岛叶皮质受刺激引发缓慢型AHM,右侧岛叶皮质受刺激引发快速型AHM;(3)脑功能损伤导致儿茶酚胺分泌增加,并在心肌积聚,造成心肌损害,引发AHM。
Objective To analyze the clinical data of arrhythmia (AHM) induced by brain injury and further improve the understanding of AHM caused by brain injury and reduce the mortality. Methods A total of 326 patients with brain dysfunction induced arrhythmia underwent brain CT examination within 48 hours after onset of disease. Patients underwent ECG and / or Holter examination within 4 days and electrocardiogram monitoring and follow - up examination as necessary. Results (1) The incidence of AHM in patients with ICH was higher than that in patients with cerebral infarction (P <0.05). (2) Slow AHM was induced in the left basal ganglia - thalamus and cerebral cortex compared with the right side (P < 0.05). There were more rapid AHMs in the right basal ganglia-thalamus and cerebral cortex than in the left (P <0.05). Conclusions (1) The left hemisphere dominated the parasympathetic nerves and the right hemisphere mainly dominated the sympathetic nerves. (2) The left insula cortex stimulated the slow AHM and the right insula cortex stimulated rapidly AHM; (3) brain function damage leads to increased catecholamine secretion, and myocardial accumulation, resulting in myocardial damage, trigger AHM.