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目的本研究的目的在于探索成年单纯颅脑损伤患者心电图改变的特征以及这些特征与发生心功能障碍之间的关系。方法回顾2013年至2014年首都医科大学大兴教学医院单纯颅脑损伤的成年患者59例。纳入入院后24h内接受12导联心电图检查并且在72h内接受超声心动图检查的单纯颅脑损伤的成年患者。排除先天性心脏病的患者。收集患者的一般临床资料、12导联心电图检查及超声心动图检查的结果。采用逻辑回归的方法检验心电图改变的特征与心功能障碍之间的相关性。结果心电图检查显示,13例(22%)出现心动过速(心率>100bpm),25例(42.4%)出现QT间期延长,6例(10.2%)出现复极末期异常表现。逻辑回归方法检验结果显示这3种心电图改变的特征与超声心动图提示的心功能障碍之间的比值比和95%可信区间分别是4.14(1.02~17.05),9.0(1.74~46.65)和5.63(1.96~32.94)。心电图中心肌缺血样改变与心功能障碍之间无相关性。结论 QT间期延长和复极末期异常表现与成年单纯颅脑损伤发生后的心功能障碍存在相关性。因此,方便且无创的12导联ECG检查可以用来筛查需要进一步进行超声心动图检查的患者。
Purpose The purpose of this study was to explore the characteristics of electrocardiographic changes in patients with adult craniocerebral injury and the relationship between these characteristics and the development of cardiac dysfunction. Methods A retrospective review of 59 patients with craniocerebral injury in Daxing Teaching Hospital, Capital Medical University from 2013 to 2014 was conducted. Adult patients admitted to a craniocerebral injury with a 12-lead electrocardiogram within 24h after admission and echocardiography within 72 hours were included. Patients with congenital heart disease were excluded. The general clinical data of patients, 12-lead ECG and echocardiography results. Logistic regression was used to examine the correlation between ECG changes and cardiac dysfunction. Results Electrocardiogram showed that 13 cases (22%) had tachycardia (heart rate> 100bpm), 25 cases (42.4%) had QT prolongation and 6 cases (10.2%) showed terminal abnormalities of repolarization. The logistic regression test showed that the odds ratios and 95% confidence intervals of the three ECG changes and echocardiographic cardiac dysfunction were 4.14 (1.02-17.05), 9.0 (1.74-46.65) and 5.63 (1.96 ~ 32.94). Electrocardiogram myocardial ischemia-like changes and cardiac dysfunction no correlation between. Conclusions There is a correlation between prolongation of QT interval and abnormal end-stage of repolarization and cardiac dysfunction after adult craniocerebral injury. Therefore, a convenient and noninvasive 12-lead ECG test can be used to screen patients for further echocardiography.