心电图异常在缺血性脑卒中患者静脉溶栓中的预测作用。
The predictive role of electrocardiographic abnormalities in ischemic stroke patients with intravenous thrombolysis.
作者信息
Wu Fei, Cao Wenjie, Ling Yifeng, Yang Lumeng, Cheng Xin, Dong Qiang
机构信息
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
出版信息
Int J Cardiol Heart Vessel. 2014 Jul 9;4:81-83. doi: 10.1016/j.ijchv.2014.06.010. eCollection 2014 Sep.
BACKGROUND/OBJECTIVES: The association between electrocardiographic abnormalities and the outcomes in acute ischemic stroke patients after intravenous thrombolysis remains unclear. We sought to assess the predictive value of electrocardiographic abnormalities in stroke patients after thrombolysis.
METHODS
Consecutive acute stroke patients with thrombolysis from Feb 2008 to Jun 2013 were included. Electrocardiographic abnormalities during hospitalization were retrospectively reviewed. Outcomes were 90-day modified Rankin's Score. Multivariate logistic regression was used to analyze the association of electrocardiographic abnormalities with 90-day outcome.
RESULTS
From Feb 2008 to Jun 2013, 95 acute stroke patients (median age of 67 and 64.2% male) with electrocardiographic before/after thrombolysis and 90 day modified Rankin's Score were recruited in our study. Increased age (p = 0.027), higher baseline National Institutes of Health Stroke Scale (p < 0.001) and T-wave changes (p = 0.030) were significantly associated with worse functional outcome. T-wave changes (odds ratio 5.54, 95% confidence interval 1.37-22.37, p = 0.016) were independently associated with unfavorable outcome.
CONCLUSIONS
T-wave changes can be useful markers to predict the outcome in stroke patients after thrombolysis.
背景/目的：急性缺血性卒中患者静脉溶栓后心电图异常与预后之间的关联仍不明确。我们旨在评估心电图异常对溶栓后卒中患者的预测价值。
方法
纳入2008年2月至2013年6月期间连续接受溶栓治疗的急性卒中患者。回顾性分析住院期间的心电图异常情况。预后指标为90天改良Rankin量表评分。采用多因素逻辑回归分析心电图异常与90天预后的关联。
结果
2008年2月至2013年6月，本研究纳入了95例急性卒中患者（中位年龄67岁，男性占64.2%），这些患者均有溶栓前后的心电图及90天改良Rankin量表评分。年龄增加（p = 0.027）、基线美国国立卫生研究院卒中量表评分较高（p < 0.001）以及T波改变（p = 0.030）与较差的功能预后显著相关。T波改变（比值比5.54，95%置信区间1.37 - 22.37，p = 0.016）与不良预后独立相关。
结论
T波改变可作为预测溶栓后卒中患者预后的有用指标。
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