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目的:分析脑卒中后脑心综合征(CCS)的临床特点,探讨其发病机制及防治措施。方法:回顾性分析2010年1月至2012年6月收治的210例急性脑卒中患者的心电图、心肌酶谱等资料。结果:210例急性脑卒中患者合并CCS者122例(58%),脑梗死组、脑出血组和蛛网膜下腔出血组中发生CCS者分别为47例(42.0%)、63例(76.8%)和12例(75.0%),其中心肌梗死患者分别为2、4、1例,出血性卒中发病率明显高于缺血性卒中(P<0.05)。122例急性脑卒中患者合并CCS患者中死亡25例(20.5%),88例无CCS患者中死亡9例(10.2%),两者比较,差异有统计学意义(P<0.05)。脑卒中后CCS患者的心电图中以ST-T延长最为常见。脑梗死组、蛛网膜下腔出血组患者CK、CK-MB、AST、LDH水平较脑出血组低(P<0.01)。结论:急性脑卒中患者易合并CCS,应加强心脏功能的监护,保护心脏功能,防止心源性猝死,提高患者生存率。
Objective: To analyze the clinical features of brain stem syndrome (CCS) after stroke and to explore its pathogenesis and prevention and treatment. Methods: The electrocardiogram and myocardial zymogram of 210 patients with acute stroke admitted from January 2010 to June 2012 were retrospectively analyzed. Results: Of the 210 patients with acute stroke, 122 (58%) had CCS and 47 (42.0%) had CCS in cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage groups, 63 (76.8% ) And 12 cases (75.0%), respectively. There were 2, 4, and 1 patients with myocardial infarction. The incidence of hemorrhagic stroke was significantly higher than that of ischemic stroke (P <0.05). Among 122 acute stroke patients, 25 (20.5%) died of CCS and 9 (88%) died of non-CCS. There was a significant difference between the two groups (P <0.05). Post-stroke ECG CCS patients with ST-T prolongation of the most common. The levels of CK, CK-MB, AST, LDH in cerebral infarction group and subarachnoid hemorrhage group were lower than those in cerebral hemorrhage group (P <0.01). Conclusion: Patients with acute stroke are likely to be associated with CCS. Heart function monitoring should be strengthened to protect cardiac function, prevent sudden cardiac death and improve patient survival.