Takeuchi Satoru, Nagatani Kimihiro, Otani Naoki, Wada Kojiro, Mori Kentaro
Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 3598513, Japan.
Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 3598513, Japan.
J Clin Neurosci. 2015 Dec;22(12):1959-62. doi: 10.1016/j.jocn.2015.04.028. Epub 2015 Sep 11.
This study investigated the prevalence and type of electrocardiography (ECG) abnormalities, and their possible association with the clinical/radiological findings in 118 consecutive patients with non-traumatic, non-neoplastic intracerebral hemorrhage (ICH). ECG frequently demonstrates abnormalities in patients with ischemic stroke and subarachnoid hemorrhage, but little is known of ECG changes in ICH patients. Clinical and radiological information was retrospectively reviewed. ECG recordings that were obtained within 24 hours of the initial hemorrhage were analyzed. Sixty-six patients (56%) had one or more ECG abnormalities. The most frequent was ST depression (24%), followed by left ventricular hypertrophy (20%), corrected QT interval (QTc) prolongation (19%), and T wave inversion (19%). The logistic regression analysis demonstrated the following: insular involvement was an independent predictive factor of ST depression (p<0.001; odds ratio OR 10.18; 95% confidence interval [CI] 2.84-36.57); insular involvement (p<0.001; OR 23.98; 95% CI 4.91-117.11) and presence of intraventricular hemorrhage (p<0.001; OR 8.72; 95% CI 2.69-28.29) were independent predictive factors of QTc prolongation; deep hematoma location (p<0.001; OR 19.12; 95% CI 3.82-95.81) and hematoma volume >30 ml (p=0.001; OR 6.58; 95% CI 2.11-20.46) were independent predictive factors of T wave inversion. We demonstrate associations between ECG abnormalities and detailed characteristics of ICH.
本研究调查了118例连续性非创伤性、非肿瘤性脑出血(ICH)患者的心电图(ECG)异常的患病率和类型,以及它们与临床/放射学检查结果之间的可能关联。心电图在缺血性卒中和蛛网膜下腔出血患者中常显示异常,但对于脑出血患者的心电图变化了解甚少。对临床和放射学信息进行了回顾性分析。分析了在初次出血后24小时内获得的心电图记录。66例患者(56%)有一项或多项心电图异常。最常见的是ST段压低(24%),其次是左心室肥厚(20%)、校正QT间期(QTc)延长(19%)和T波倒置(19%)。逻辑回归分析显示:岛叶受累是ST段压低的独立预测因素(p<0.001;优势比OR 10.18;95%置信区间[CI] 2.84 - 36.57);岛叶受累(p<0.001;OR 23.98;95% CI 4.91 - 117.11)和脑室内出血的存在(p<0.001;OR 8.72;95% CI 2.69 - 28.29)是QTc延长的独立预测因素;深部血肿位置(p<0.001;OR 19.12;95% CI 3.82 - 95.81)和血肿体积>30 ml(p = 0.001;OR 6.58;95% CI 2.11 - 20.46)是T波倒置的独立预测因素。我们证明了心电图异常与脑出血的详细特征之间的关联。