摘要
目的探讨自发性脑出血患者心电图改变与其急性期预后的关系。方法分析183例自发性脑出血患者的出血部位和出血量与心电图改变的关系,并且进行自发性脑出血急性期预后以及异常心电图的Logistic回归分析,分析心电图改变与其急性期预后的关系。结果 183例自发性脑出血患者的出血部位位于脑干44例、丘脑21例、基底节42例、小脑76例,其心电图异常者分别有35例(79.5%)、16例(76.2%)、21例(50.0%)、31例(40.8%),不同出血部位的心电图异常者比例差异有统计学意义(χ~2=21.638,P<0.05),病灶位于中线结构处,心电图异常者多。少量出血(幕上)组(出血量≤10 m L)20例,中等量出血(幕上)组(10 m L<出血量为<30 m L)25例,大量出血组(出血量≥30 m L)18例,各组心电图异常者分别有7例(35.0%)、18例(72.0%)、16例(88.9%),3组心电图异常者比例比较差异有统计学意义(χ~2=12.979,P<0.05),中等量以及大量出血组心电图异常者较少量出血组多(χ~2分别为6.161和11.515,P<0.05),而中等量以及大量出血组两者之间差异无统计学意义(χ~2=1.804,P>0.05)。死亡组69例中心电图异常者51例(73.9%),存活组114例中心电图异常者为52例(45.6%),2组间差异有统计学意义(χ~2=13.990,P<0.05)。通过自发性脑出血急性期预后以及异常心电图的Logistic回归分析发现,ST-T改变、U波异常和长QT间期是自发性脑出血急性期死亡的危险因素。结论积极治疗脑部原发疾病的同时应密切监测心电图的变化并及时处理,防止急性期死亡的发生。
Objective To study the relationship between changes of electrocardiogram(ECG)and the prognosis of patients with acute spontaneous intracerebral hemorrhage.Methods The relationship between ECG changes and location data of intracerebral hemorrhage in183patients was analyzed.The prognosis of spontaneous intracerebral hemorrhage in acute stage and the abnormal ECG were analyzed by Logistic regression analysis.Results In183patients,there were44cases of brainstem hemorrhage,21cases of thalamic hemorrhage,42cases of basal ganglia hemorrhage and76cases of cerebellar hemorrhage.In these patients,there were abnormal ECG findings in35cases(79.5%),16cases(76.2%),21cases(50.0%)and31cases(40.8%).There were significant differences in the proportions of patients with ECG abnormalities in different bleeding sites(χ2=21.638,P<0.05).Abnormal ECG was more common when intracerebral hemorrhage was located at the midline structures.According to the hematoma volumes,there were20cases with hematoma volumes≤10mL(35.0%),25cases with hematoma volumes between10mL-30mL(72.0%)and18cases with hematoma volumes≥30mL(88.9%).There were7cases with abnormal ECG,18cases with abnormal ECG and16cases with abnormal ECG in these three groups of patients.There were significant differences in the proportions of patients with ECG abnormalities between three groups(χ2=12.979,P<0.05).There were more patients with abnormal ECG in hematoma volumes between10mL-30mL group and hematoma volumes≥30mL group than those of patients with hematoma volumes≤10mL group(χ2=6.161and11.515,P<0.05).There was no significant difference in patients with ECG abnormalities between hematoma volumes of10mL-30mL group and hematoma volumes≥30mL group(χ2=1.804,P>0.05).There were51cases with abnormal ECG in69cases of death group(73.9%).There were52cases with abnormal ECG in114cases of survival group(45.6%).There was significant difference between the two groups(χ2=13.990,P<0.05).Logistic regression analysis revealed that the ST-T change,U-wave abnormality and long QT interva
作者
朱玮
杨鹏
ZHU Wei;YANG Peng(The First Affiliated Hospital of Suzhou University, Suzhou 215000, China)
出处
《天津医药》
CAS
2017年第11期1202-1205,共4页
Tianjin Medical Journal
基金
苏州市科技计划项目(SYS201616)
关键词
脑出血
心电描记术
预后
自发性脑出血
异常心电图
cerebral hemorrhage
electrocardiography
prognosis
spontaneous intracerebral hemorrhage
abnormal ECG
