王艳茹　周国亮　张月婵　白凤英　宋桂菊

[摘要] 目的 探讨脑梗死患者的心电图变化情况，从而为防治脑血管疾病及改善预后提供指导依据。 方法 选取2017年6月～2018年3月我院住院治疗的50例急性重症脑梗死患者，入院24 h内利用标准同步12导联心电图机进行心电图检查，同时利用B19800型便携式动态心电图机检查并记录24 h心电图的变化情况。 结果 50例脑梗死患者经心电图或心电监护发现其中40例有心电图异常，以心律失常最常见。40例有心电图异常表现的脑梗死患者中，位于基底节31例（77.5%）、丘脑6例（15.0%）、小脑1例（2.5%）、蛛网膜下腔1例（2.5%）、脑叶1例（2.5%）。50例急性重症脑梗死患者中出现心电图异常40例，死亡12例，病死率30.0%；其余10例心电图正常患者出现心电图异常1例，病死率10.0%。心電图异常的急性重症脑梗死患者的病死率明显高于心电图正常的急性重症脑梗死患者的病死率（P<0.05）。 结论 分析脑梗死患者的心电图变化情况，对于急性重症脑梗死患者预后的评估具有重要的指导作用。

[关键词] 急性重症脑梗死；心电图；年龄；预后

[中图分类号] R743.3 [文献标识码] B [文章编号] 1673-9701（2018）26-0046-03

Electrocardiogram analysis of 50 patients with acute severe cerebral infarction

WANG Yanru ZHOU Guoliang ZHANG Yuechan BAI Fengying SONG Guiju

Second Department of Internal Medicine， Hengshui Jizhou District Hospital in Hebei Province， Hengshui 053200， China

[Abstract] Objective To investigate and analyze the changes of electrocardiogram in patients with cerebral infarction， so as to provide guidance for prevention and treatment of cerebrovascular diseases and improvement of prognosis. Methods A total of 50 patients with acute severe cerebral infarction who were hospitalized in our hospital from June 2017 to March 2018 were enrolled. The electrocardiogram was performed within 24 hours of admission using a standard synchronous 12-lead ECG machine. At the same time， the B19800 portable dynamic electrocardiograph was used to check and the changes in 24 h-ECG were recorded. Results In 50 patients with cerebral infarction， 40 had ECG abnormalities by electrocardiogram or ECG monitoring， and arrhythmia was the most common. Of the 40 cerebral infarction patients with abnormal ECG， 31 were located in the basal ganglia （77.5%），6 in the thalamus （15.0%）， 1 in the cerebellum （2.5%）， and 1 in the subarachnoid space （2.5%）， 1 case of brain lobe （2.5%）. Among the 50 patients with acute severe cerebral infarction， 40 had abnormal electrocardiogram， 12 died， and the mortality rate was 30.0%.1 in the other 10 patients with abnormal electrocardiogram had abnormal electrocardiogram， and the mortality rate was 10.0%. The mortality rate of patients with acute severe cerebral infarction with abnormal electrocardiogram was significantly higher than that of patients with acute severe cerebral infarction with normal electrocardiogram（P<0.05）. Conclusion Analysis of changes in ECG in patients with cerebral infarction has important guiding role in evaluating the prognosis of patients with acute severe cerebral infarction.

[Key words] Acute severe cerebral infarction； Electrocardiogram； Age； Prognosis

脑梗死是神经系统的常见病、多发病，临床上包括脑血栓形成、腔隙性脑梗死、脑栓塞等类型[1]。研究发现，脑梗死患者若合并严重心脏疾病，则使其死亡率显著增加[2]。急性脑血管病患者心电图异常变化的表现与患者病情的严重程度和预后密切相关，可作为判断其预后效果的临床指标之一。心电图是反映心脏功能的重要指标，因此，探讨分析脑梗死患者的心电图变化情况，对防治脑血管疾病及改善预后具有重要的临床价值。本研究对50例急性重症脑梗死患者的心电图资料进行分析，现报道如下。……