左右侧大面积大脑中动脉供血区梗死继发心电图改变的预后研究

A prognostic study of electrocardiogram changes secondary to acute right and left large-scale middle cerebral artery infarction

摘要:

目的 探讨左右侧大面积大脑中动脉（MCA）急性梗死继发心电图改变的预后。为临床早期评估及干预提供参考数据。方法 选择兰州大学第二医院自2014年12月至2016年3月收治的54例急性MCA大面积脑梗死患者，按梗死部位分为左侧脑梗死组（n=20）和右侧脑梗死组（n=34），分别对两组患者入院时、1月、3月及6月时的美国国立卫生研究院卒中量表（NIHSS）评分、Barthel指数（BI）及改良Rankin（mRS）评分进行比较。结果 左侧脑梗死组和右侧脑梗死组在1月内病死率比较，差异无统计学意义（χ²=1.975，P>0.05）。两组患者发病6月时BI评分比较，差异有统计学意义（t=-3.161，P<0.05）。两组患者在1月、3月及6月时的NIHSS评分比较，无论是否继发心电图改变，差异均有统计学意义（P<0.05）。结论 不同侧大面积MCA梗死继发心电图改变的预后可能不同。

Abstract:

Objective To investigate the prognosis of electrocardiogram (ECG) changes secondary to acute right and left large-scale middle cerebral artery (MCA) infarction, and to provide reference data for early clinical evaluation and intervention.Methods A total of 54 patients with acute large-scale MCA infarction who were admitted to our hospital from December 2014 to March 2016 were enrolled and divided into left MCA infarction group (n=20) and right MCA infarction group (n=34). National Institutes of Health Stroke Scale (NIHSS) score, Barthel index (BI), and modified Rankin score on admission and at 1, 3, and 6 months after onset were compared between the two groups.Results There was no significant difference in mortality within the first month between the two groups (χ²=1.975, P>0.05). The left MCA infarction group had a significantly lower BI score at 6 months after onset than the right MCA infarction group (t=-3.161, P<0.05). No matter whether there were secondary ECG changes, the left MCA infarction group had significantly higher NIHSS scores at 1, 3, and 6 months after onset than the right MCA infarction group (all P<0.05).Conclusions The prognosis may be different between patients with ECG changes secondary to right and left large-scale MCA infarction.