【摘要】 目的探讨急性脑卒中患者心电图异常宽大T波的发生情况及临床意义。方法依据心电图纳入标准,从2 580例急性脑卒中患者中筛选出53例为宽大T波组,2 527例为非宽大T波组,统计头部CT或MRI、DWI检查结果,肌钙蛋白(cTnT)、磷酸肌酸激酶同工酶(CK-MB)、N末端B型利钠肽原(NT-proBNP)、电解质、超声心动图、临床转归等临床指标。结果 2 580例急性脑卒中病例的异常宽大T波发生率为2.05%,其中546例蛛网膜下腔出血患者发生率为6.59%,724例脑出血患者发生率为1.24%,1 310例脑梗死患者发生率为0.61%。cTnT、CK-MB增高在宽大T波组的发生率分别为92.45%、86.79%,非宽大T波组分别为11.20%、10.00%,组间差异有统计学意义(均P<0.01)。宽大T波组与非宽大T波组的住院病死率分别为22.64%、4.50%(P<0.01),女性宽大T波多于男性。结论异常宽大T波多发生于蛛网膜下腔出血患者,颅内压显著增高、儿茶酚胺性心肌损害程度较重可能是引起异常宽大T波的主要原因,异常宽大T波可在一度程度上反映卒中患者的病情严重性。更多还原

【Abstract】 Objective To investigate the incidence and clinical significance of the abnormal wide T waves on ECG in patients with acute stroke.Methods A total of 2 580 patients with acute stroke were enrolled according to the results of ECG.They were divided into wide T wave group(53cases)and non-wide T wave group(2 527cases).Clinical data were collected including head CT,MRI,DWI results,clinical indexes such as troponin(cTnT),creatine kinase isoenzyme(CK-MB),N terminal B type natriuretic peptide(NT-proBNP),electrolytes,echocardiogram and clinical outcome.Results The incidence of abnormal wide T waves was 2.05%in 2 580 cases of acute stroke,and it was 6.59%in 546 patients with subarachnoid hemorrhage,1.24%in 724 patients with cerebral hemorrhage,0.61%in 1 310 patients with cerebral infarction.The incidences of increased cTnT and CK-MB were 92.45%,86.79%in wide T wave group and 11.20%,10.00%in non-wide T wave group,respectively.The in-hospital mortality was 22.64%,4.50%in the two groups respectively(P<0.01).Women were more likely than men to have abnormal wide T waves.Conclusion Abnormal wide T waves mainly occurred in patients with the subarachnoid hemorrhage.The intracranial hypertension and catecholamine-induced myocardial damage may be the main reasons for abnormal wide T waves.Abnormal wide T waves can reflect the severity of stroke to some extent.更多还原