不同部位急性脑卒中并发脑心综合征临床特征的差异

发布时间：2018-06-22 01:25

本文选题：急性脑卒中 + 脑心综合征　；参考：《中国老年学杂志》2017年17期

【摘要】：目的探讨不同部位急性脑卒中并发脑心综合征(CCS)临床特征的差异性。方法 311例急性缺血性脑卒中患者,分为一侧基底节区脑梗死112例、脑干梗死94例、一侧小脑梗死105例。291例急性出血性脑卒中患者,分为一侧基底节区脑出血108例,脑干出血87例,一侧小脑出血96例。分别进行不同部位缺血性脑卒中及出血性脑卒中心电图、心肌酶、肌钙蛋白的比较,并进行同一部位缺血性脑卒中、出血性脑卒中心电图、心肌酶、肌钙蛋白的比较。结果在缺血性脑卒中,脑干梗死、一侧基底节区脑梗死及一侧小脑梗死心电图、心肌酶、肌钙蛋白的变化差异有统计学意义(P0.05)。其中脑干梗死与其他两组比较上述指标变化有明显差异(P0.01),而一侧基底节脑梗死与一侧小脑梗死上述指标变化无统计学差异(P0.05)。在出血性脑卒中,脑干出血与一侧基底节区脑出血及一侧小脑出血心电图、心肌酶、肌钙蛋白的变化差异显著(P0.01),而一侧基底节区脑出血与一侧小脑出血心电图变化无统计学差异(P0.05),而心肌酶、肌钙蛋白的变化有统计学差异(P0.01)。急性脑干梗死与脑干出血相比,心电图、心肌酶、肌钙蛋白的变化差异显著(P0.01),一侧基底节区急性脑梗死与脑出血心电图、心肌酶、肌钙蛋白的变化亦有差异(P0.05),一侧小脑梗死与出血心电图、心肌酶、肌钙蛋白的变化无差异(P0.10)。结论急性脑干卒中较一侧基底节、一侧小脑卒中更易发生CCS,且脑干、基底节区出血性脑卒中较对应部位的缺血性脑卒中更易发生CCS。临床上应加强对急性脑卒中心电图、心肌酶、肌钙蛋白的监测,尤其是出血性脑卒中的患者,同时应加强对CCS的干预治疗。
[Abstract]:Objective to investigate the clinical characteristics of acute stroke complicated with cerebral heart syndrome (CCS). Methods 311 patients with acute ischemic stroke were divided into unilateral basal ganglia infarction (n = 112), brainstem infarction (n = 94), unilateral cerebellar infarction (n = 105) and acute hemorrhagic stroke (n = 291). There were 87 cases of brainstem hemorrhage and 96 cases of unilateral cerebellar hemorrhage. The electrocardiogram (ECG), myocardial enzyme and troponin were compared in different ischemic stroke and hemorrhagic stroke, and the electrocardiogram (ECG), myocardial enzyme and troponin were compared between ischemic stroke and hemorrhagic stroke. Results the changes of ECG, myocardial enzymes and troponin in ischemic stroke, brainstem infarction, unilateral basal ganglia infarction and unilateral cerebellar infarction were significantly different (P0.05). The changes of the above indexes were significantly different between the two groups (P0.01), but there was no statistical difference between the unilateral basal ganglia infarction and the unilateral cerebellar infarction (P0.05). In hemorrhagic stroke, brainstem hemorrhage with unilateral basal ganglia hemorrhage and side cerebellar hemorrhage ECG, myocardial enzymes, There was significant difference in cardiac troponin (P0.01), but there was no significant difference in ECG between unilateral basal ganglia hemorrhage and unilateral cerebellar hemorrhage (P0.05), while the changes of myocardial enzymes and troponin were statistically different (P0.01). There were significant differences in electrocardiogram (ECG), myocardial enzyme, cardiac troponin (P0.01) between acute brainstem infarction and cerebral stem hemorrhage (P0.01). The changes of cardiac troponin were also different (P0.05), but there was no difference in ECG, myocardial enzyme and troponin between unilateral cerebellar infarction and hemorrhage (P0.10). Conclusion CCS is more likely to occur in acute brainstem stroke than in one side of basal ganglia and one side of cerebellar stroke, and cerebral stem and basal ganglia hemorrhagic stroke are more likely to occur in ischemic stroke. Clinical monitoring of electrocardiogram, myocardial enzyme and troponin, especially in patients with hemorrhagic stroke, should be strengthened, and the intervention of CCS should be strengthened.
【作者单位】：新疆维吾尔自治区人民医院北院急诊病房;
【分类号】：R743.33

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