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目的:观察急性脑卒中患者心率振荡现象的特点并探讨其与死亡的关系。方法:急性脑卒中患者123例(左侧脑梗死44例,右侧脑梗死45例,脑出血34例),单纯高血压组66例,入院后测患者基础血压,72h内行24hHolter监测,获取心率振荡的参数振荡起始(TO)及振荡斜率(TS)。结果:左侧脑梗死组、右侧脑梗死组、脑出血组与单纯高血压组各组间年龄、舒张压、收缩压均差异无统计学意义(P>0.05),急性脑卒中各组与单纯高血压组比较,TO、TS均差异有统计学意义(P<0.01)。左侧脑梗死、右侧脑梗死与脑出血组比较TO差异有统计学意义,TS差异无统计学意义。123例急性脑卒中患者住院期间死亡20例,其中左侧脑梗死组4例,右侧脑梗死组5例,脑出血组11例。死亡的患者与生存的患者相比TO差异有统计学意义(P<0.05),TO与死亡有明显的相关性。结论:急性脑卒中患者较单纯高血压患者的自主神经受损严重,其中以脑出血对自主神经的损伤更为明显,TO可以作为急性脑卒中患者的预后指标。
Objective: To observe the characteristics of heart rate oscillations in patients with acute stroke and to explore their relationship with death. Methods: 123 cases of acute stroke patients (left cerebral infarction 44 cases, right cerebral infarction 45 cases, cerebral hemorrhage 34 cases), simple hypertension group 66 cases, after admission to patients with basal blood pressure, 72h line 24hHolter monitoring, access to heart rate Oscillation parameters Oscillation start (TO) and oscillation slope (TS). Results There were no significant differences in age, diastolic blood pressure and systolic blood pressure between left cerebral infarction group, right cerebral infarction group, cerebral hemorrhage group and simple hypertensive group (P> 0.05) Compared with simple hypertension group, the differences of TO and TS were statistically significant (P <0.01). Left cerebral infarction, right cerebral infarction and cerebral hemorrhage group compared TO difference was statistically significant, TS difference was not statistically significant. Among 123 acute stroke patients, 20 died during hospitalization, including 4 in left cerebral infarction group, 5 in right cerebral infarction group and 11 in cerebral hemorrhage group. TO patients with death compared with the survival of patients was statistically significant difference (P <0.05), TO and death were significantly associated. Conclusions: Autonomic nervous dysfunction is more serious in patients with acute stroke than that in patients with simple hypertension. The intracerebral hemorrhage is more obvious on autonomic nerve injury. TO may be used as a prognostic indicator in patients with acute stroke.