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目的 探讨不同部位脑出血患者心脏自主神经活性变化、ECG异常的动态演变。方法 动态检测 12 8例高血压性脑出血患者和 12 8例年龄配对对照高血压患者的心率变异性和标准 12导联ECG ,分析不同部位出血对心脏自主神经活性和ECG的影响及其动态演变。结果 右侧壳核和额顶颞叶出血患者快速心律失常和QTc延长发生率显著增加 ,左侧壳核和额顶颞叶出血患者ST段上升或下降显著增加 ;右侧壳核和额顶颞叶出血患者心率变异性高频功率谱 (HF)明显降低 ,心脏副交感神经活性降低 ;低频功率谱与高频功率谱的比值 (LF/HF)明显升高 ,心脏交感神经活性相对增强 ;心电图异常和心率变异性变化在病程前 4天明显。结论 脑出血患者心电图异常和心脏自主神经活性变化主要出现在病程前 4天 ,对脑出血患者急性期应加强心电监护和心脏保护。
Objective To investigate the dynamic changes of cardiac autonomic nerve activity and ECG abnormalities in patients with cerebral hemorrhage at different sites. Methods The heart rate variability (HRV) of 12 8 hypertensive cerebral hemorrhages and 12 matched age-matched hypertensive patients were measured dynamically and the standard 12-lead ECG was used to analyze the effects of different sites of hemorrhage on cardiac autonomic nervous activity and ECG and its dynamic evolution . Results The incidences of tachyarrhythmia and QTc prolongation in the right putamen and frontal temporal lobe hemorrhage were significantly increased. The ST segment elevation and decrease in the left putamen and frontotemporal temporal lobe hemorrhage were significantly increased. The right putamen and forehead temporal lobe Heart rate variability in patients with leaf hemorrhage HF power was significantly reduced, cardiac parasympathetic activity decreased; low frequency power spectrum and high frequency power spectrum ratio (LF / HF) was significantly increased cardiac sympathetic activity relatively enhanced; abnormal ECG And heart rate variability in the course of 4 days before the obvious. Conclusion Electrocardiogram abnormalities and cardiac autonomic nerve activity in patients with intracerebral hemorrhage mainly occur in the first 4 days of course of disease. ECG monitoring and cardioprotection should be strengthened in patients with acute cerebral hemorrhage.