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目的分析急性脑血管病心电图异常的特点,并讨论其发生的机制。方法对249例经头颅CT确诊为急性脑血管病患者在入院24 h内做标准导联心电图检查。结果 249例患者心电图的异常率为69.1%(172/249),其中脑出血异常率64.3%(18/28);脑梗死异常率69.7%(154/221),两者比较差异无统计学意义(P<0.05)。ST-T改变的发生率最高,其次为传导阻滞,与Q-T间期延长、p波增宽、左心室肥厚、心律失常、低电压比较差异有统计学意义(P<0.05)。心电图正常组病死率1.3%(1/77),心电图异常组病死率7.6%(13/172),两组病死率比较差异有统计学意义(P<0.05)。结论急性脑血管病患者中心电图异常发生率较高,以心肌缺血和传导阻滞为主。心电图异常组病死率高,临床工作中应关注急性脑血管病患者的心电图改变,及时给予适当处理。
Objective To analyze the characteristics of electrocardiogram abnormalities in acute cerebrovascular disease and to discuss its mechanism. Methods 249 patients who were diagnosed as acute cerebrovascular disease by skull CT were examined by standard lead electrocardiogram within 24 hours after admission. Results The abnormal rate of electrocardiogram was 69.1% (172/249) in 249 patients, of which the rate of abnormal cerebral hemorrhage was 64.3% (18/28) and the rate of abnormal cerebral infarction was 69.7% (154/221), the difference was insignificant (P <0.05). The incidence of ST-T changes was the highest, followed by conduction block. There was a significant difference between Q-T prolongation, p-wave broadening, left ventricular hypertrophy, arrhythmia, and low voltage (P <0.05). The mortality of normal group was 1.3% (1/77) and that of abnormal ECG was 7.6% (13/172). There was significant difference between the two groups (P <0.05). Conclusion The incidence of ECG abnormalities in patients with acute cerebrovascular disease is high, mainly myocardial ischemia and conduction block. Electrocardiogram abnormalities high mortality, clinical work should pay attention to patients with acute cerebrovascular disease ECG changes, timely and appropriate treatment.