脑损伤患者动态心电异常的临床观察

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1、脑损伤患者动态心电异常的临床观察作者：郭彩霞，杜凤和,徐晓微单位：首都医科大学附属北京天坛医院心内科，北京100050【摘要】目的观察脑损伤患者的动态心电图改变，了解急性脑损伤致心电异常的特点及其与损伤部位和严重程度的关系。方法：选取我院急性脑损伤患者56例，经Glasgow评分分型,脑CT确定损伤部位，并行24h动态心电图检查，观察急性脑损伤肩心电异常的发生情况，并根据脑损伤部位和严重程度分组观察，以了解其心电异常的特点。结果：急性脑损伤患者心电异常发生率为57.14%,其中50%患者出现ST・T异常。急性脑损伤后血肿部位和严重程度

2、不同，心电异常的发牛特点也不同，按部位分脑内血肿心电异常率故高，达71.43%,按Glasgow评分重型脑损伤心电显常率故高，达73.08%(P均0.05)。结论：急性脑损伤患者心电异常表现为心律失常和ST-T异常，且与脑损伤部位和严重程度有关。【关键词】脑损伤；心电描记术，便携式；心律失常基金资助：国家自然科学基金(30740054)、首都更学发展科研基金(2002-2025)ChangesofdynamicelectrocardiograminpatientswithbraininjuryGUOCai-xia,DUFeng-he,

3、XUXiao-weiAuthor′saddress：DepartmentofCardiologyMedicine,BeijingTiantanHospital,CapitalMedicalUniversity,Beijing,100050,ChinaAbstract：ObjectiveTostudythechangesofdynamicelectrocardiograminpatientswithbraininjury.MethodsFifty-sixpatientswithacutebraininjurywererecr

4、uitedinthisstudy.TheGlasgowcomascale,theinitialcomputedtomogramandambulatoryelectrocardiogramwereperformedinallsubject.Datawereanalyzedaccordingtodifferentplaceandseverityofbraininjury.ResultsECGabnormalitieswerefoundin32patientsoutof56patientswithacuteheadinjury(57.14%

5、)・ST-Tabnormitieswerefoundinhalfofthebraininjurypatients.Sinustachycardia,frequentatrialprematurebeats,atrialtachycardiaandventriculartachycardiawererecordedamongarrhythmias.ECGabnormalitieswerepresentin71.43%ofpatientswithintracerebralhaematoma,66.67%ofpatientswithsubd

6、uralhaematomaand36.84%ofpatientswithextraduralhaematoma(P0.05all).Thebraininjurydividedintosevere,moderateandmilddegreeaccordingGlasgowcomascale.ECGabnormalitieswerepresentin73.08%ofseverepatients,63.64%ofmoderatepatientsand36.84%ofmildpatientswithacutebraininjury(P0.05

7、all).ConclusionAcutebraininjurycanleadtoarrhythmiaandST-Tabnormalities.ECGabnormalitiesareassociatedwithplaceandseverityofbraininjury.Keywords:Braininjury;Electrocardiography,ambulatory;Arrhythmia急性脑损伤可引起心律失常、心力衰竭等心血管功能损害［1］,并对能增加脑损伤的死亡率，减少心脏移植供体［2］。国内外对脑损伤后的心电图改变己有较多报道

8、［3,4］,但多为常规心电图记录，缺乏心电动态连续描记。为此，我们观察了56例急性脑损伤患者的24h动态心电图改变，以了解急性脑损伤所致心电异常的特点及其•损伤部位和严至程度的关系。1资料与方法L1一般资料选取我院56例