急性丘脑卒中并发脑心综合征64例研究.doc

急性丘脑卒中并发脑心综合征64例研究[摘要] 目的 探讨急性丘脑卒中并发脑心综合征(BHS)的临床特征及发病机制。方法 回顾性分析64例BHS患者的临床资料。结果 急性丘脑卒中患者脑心综合征发生率为38.1%,其中76.6%的患者在急性丘脑卒中后72h内发病。心脏损害主要表现为心电图复极异常、心肌缺血或类心肌梗死、各类型心律失常,心肌酶谱升高,并且BHS随着病情的好转而好转,病死率为39.1%。结论 急性丘脑卒中BHS发生率高,BHS的发生与丘脑卒中相关联,可能与丘脑受损导致自主神经中枢功能失调、心脏神经支配紊乱、神经-体液调节障碍等有关。 [关键词] 急性丘脑卒中;脑心综合征 [中图分类号] R743.3 [中图分类号] A[文章编号] 1673-9701(2009)24-109-02 The Clinical Characteristics of Brain-heart Syndrome in Patients with Acute Thalamic Stroke:A Analysis of 64 Cases CHEN Xiuqing1DU Chuanqing2 1.The Health School of Dengzhou City,Henan;2.The People?s Hospital of Dengzhou City,Henan 474150,China [Abstract] Objective To investigate the clinical characteristics and pathogenesis of brain-heart syndrome(BHS) in patients with acute thalamic stroke. Methods The clinical data of 64 cases of BHS in patients with thalamic stroke were reviewed and analyzed retrospectively. Results The incidence of BHS was 38.1 % in thalamic stroke patients,and 76.6% of them were attacked with BHS within 72 hours after thalamic stroke onset. The main manifestations of myocardial injury were re-polarization abnormality,arrhythmia on ECG and increaseing in cardiac enzymes. As thalamic stroke was controlled,BHS was alleviatde gradually. The total death rate was 39.1%. Conclusion BHS causes high mortality rate in patients with thalamic stroke. The pathogenesis may be related to the disturbance of autonomic nervous center,cardiac innervation andneural - humoral regulation resulted from the injury of thalamus. [Key Words] Acute thalamic stroke;Brain-heart syndrome 脑心综合征(BHS)是指急性脑血液循环障碍时所发生的心脏损害[1],直接影响患者的预后和生存率。丘脑作为大脑皮层下非常重要的中枢,急性丘脑卒中后并发BHS受到临床医师的广泛重视。本文对我院收治的急性丘脑卒中并发BHS的64例患者进行回顾性临床资料分析,现报道如下。 1资料与方法 1.1临床资料 选取急性丘脑卒中168例住院患者,诊断均符合1995年全国脑血管病学术会议制定的诊断标准,所有病例均经头颅CT或MRI证实,丘脑出血59例,丘脑梗死109例。其中确诊脑心综合征64例,男44例,女20例;年龄45～80岁,平均67岁;发病时间1～96h,平均24h;丘脑出血27例,丘脑梗死37例。 1.2诊断标准 ①患者及家属否认病前心脏病史,丘脑卒中发生后有心电图异常或心肌酶谱升高。②病前有心脏病史,丘脑卒中发生后心电图出现新的异常或心肌酶谱升高。③随着病情好转,心电图及心肌酶谱逐渐恢复正常。 1.3方法 1.