任永霞

[摘要] 目的 探讨急性脑血管病患者心肌酶的变化及意义。 方法 回顾性分析沂南县人民医院（以下简称“我院”）2015年8月～2016年12月收治的急性脑血管病患者68例（急性脑血管病组）的临床资料。选取我院同期健康体检者55名作为正常对照组。测定研究对象的天门冬氨酸氨基转移酶（AST）、乳酸脱氢酶（LDH）、α-羟丁酸脱氢酶（α-HBDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）水平，并行心电图检查。 结果 急性脑血管病组患者AST、LDH、α-HBDH、CK水平均明显高于正常对照组（P < 0.05）。脑梗死组和脑缺血组各项心肌酶谱水平比较，差异均无统计学意义（P > 0.05）。据中国脑卒中神经功能缺损程度评分，中型组急性脑血管病患者CK水平明显高于轻型组（P < 0.05），重型组各项心肌酶谱水平均明显高于轻型组（P < 0.05）。无意识障碍组患者各项心肌酶谱指标水平均明显低于意识障碍组（P < 0.05）。心电图正常组与心电图异常组各项心肌酶谱水平比较，差异均无统计学意义（P > 0.05）。 结论 急性脑血管病会损伤心功能，引起心肌酶的改变，其变化可能与病情严重程度、有无意识障碍有关。心肌酶可考虑作为判断急性脑血管病患者病情轻重及预后的指标。

[关键词] 急性脑血管病；心肌酶；心电图

[中圖分类号] R73 [文献标识码] A [文章编号] 1673-7210（2017）10（a）-0129-04

[Abstract] Objective To investigate the changes and significance of myocardial enzyme in the patients with acute cere？鄄brovascular disease. Methods The clinical data of 68 patients with acute cerebrovascular disease （acute cerebrova？鄄scular disease group） admitted to People′s Hospital of Linyi City （"our hospital" for short） from August 2015 to December 2016 was analyzed retrospectively， 55 cases of healthy control in our hospital at the same time were selected as normal control group. The levels of aspartate aminotransferase （AST）， lactic dehydrogenase （LDH）， α-hydroxybutyrate dehydrogenase （α-HBDH）， creatine kinas （CK）， creatine Kinase Isoenzyme （CK-MB） were detected， and electrocardio？鄄gram was examined. Results The levels of AST， LDH， α-HBDH， CK in the acute cerebrovascular disease group were all higher than those of acute cerebrovascular disease group， the differences were all statistically significant （P < 0.05）. There were no statistically significant differences of all indexes of myocardial enzyme between cerebral infarction group and cerebral ischemia group （P > 0.05）. According to China stroke scale， the levels of CK in the medium group were signi？鄄ficantly higher than those of light group （P < 0.05）， the levels of all indexes of myocardial enzyme in the severe group were all higher than those of light group， the differences were all statistically significant （P < 0.05）. The levels of all indexes of myocardial enzyme in the non-conscious disturbance group were all lower than those of conscious disturbance group， the differences were all statistically significant （P < 0.05）. There were no statistically significant differences of all indexes of myocardial enzyme between normal electrocardiogram group and abnormal electrocardiogram group （P > 0.05）. Conclusion Acute cerebrovascular disease can damage cardiac function， cause the changes of myocardial enzyme， which may be related to the severity of illness， conscious disturbance or not. Myocardial enzyme can be considered as the indexes of judging the severity degree of illness and prognosis of patients with acute cerebrovascular disease.endprint

[Key words] Acute cerebrovascular disease； Myocardial enzyme； Electrocardiography

急性脑血管病是由脑部或支配脑的颈部动脉病变引起的单处或多处急性脑血管循环障碍和暂时或永久性的脑功能障碍，其发病率和致残、致死率均较高，且发病率呈逐年上升趋势[1-2]。尽管CT、MRI等现代技术提高了对急性脑血管病的诊断率，医疗科技的发展也为急性脑血管病提供了更优的治疗手段，但急性脑血管病仍然有着居高不下的病死率，严重威胁人类生命安全[3]。急性脑血管病临床常合并继发性心脏功能损害，如心肌缺血、心律失常、心力衰竭等，称为脑心综合征，临床可见心肌酶和心电图等的异常改变。……