中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
7期
1-3
,共3页
高血压脑出血%肌酸激酶同工酶%肌钙蛋白I%心电图
高血壓腦齣血%肌痠激酶同工酶%肌鈣蛋白I%心電圖
고혈압뇌출혈%기산격매동공매%기개단백I%심전도
Hypertensivc cerebral hemorrhage%Isoenzyme of creatine kinasetroponin I%Electrocardiogram
目的 探讨高血压脑出血患者早期血清CKMB、cTnI和EKG异常改变与病情严重程度、出血量大小和出血部位的关系及其临床意义.方法 选择48例高血压脑出血患者,进行动态GCS评分及CT检查,计算出血量,判断出血部位及出血是否破入脑室,入院24 h内、72 h、7 d和15 d抽晨血测定CKMB、cTnI和心电图检查.结果 高血压脑出血患者在发病24 h内血清CKMB、cTnI和EKG异常率分别是12.50%、25.00%和54.17%,72 h异常率达到高峰,为33.33%、54.17%和77.08%,以后逐渐下降.发病72 h内有意识障碍组CKMB、cTnI和EKG异常率明显高于无意识障碍组,出血量＞40 ml组明显高于出血量＜40 ml组,差异有统计学意义;而不同出血部位和出血有无破入脑室组比较,其血清CK-MB、cTnI和EKG异常率相近,对比差异无统计学意义.结论 高血压脑出血患者早期普遍存在血清CKMB、cTnI异常升高和心电图异常,其异常与脑出血量的大小及病情严重程度有关,与出血部位和出血是否破入脑室无关.高血压脑出血患者早期进行血清CKMB、cTnI监测和EKG检查对判断病情的严重程度有重要的临床意义.
目的 探討高血壓腦齣血患者早期血清CKMB、cTnI和EKG異常改變與病情嚴重程度、齣血量大小和齣血部位的關繫及其臨床意義.方法 選擇48例高血壓腦齣血患者,進行動態GCS評分及CT檢查,計算齣血量,判斷齣血部位及齣血是否破入腦室,入院24 h內、72 h、7 d和15 d抽晨血測定CKMB、cTnI和心電圖檢查.結果 高血壓腦齣血患者在髮病24 h內血清CKMB、cTnI和EKG異常率分彆是12.50%、25.00%和54.17%,72 h異常率達到高峰,為33.33%、54.17%和77.08%,以後逐漸下降.髮病72 h內有意識障礙組CKMB、cTnI和EKG異常率明顯高于無意識障礙組,齣血量＞40 ml組明顯高于齣血量＜40 ml組,差異有統計學意義;而不同齣血部位和齣血有無破入腦室組比較,其血清CK-MB、cTnI和EKG異常率相近,對比差異無統計學意義.結論 高血壓腦齣血患者早期普遍存在血清CKMB、cTnI異常升高和心電圖異常,其異常與腦齣血量的大小及病情嚴重程度有關,與齣血部位和齣血是否破入腦室無關.高血壓腦齣血患者早期進行血清CKMB、cTnI鑑測和EKG檢查對判斷病情的嚴重程度有重要的臨床意義.
목적 탐토고혈압뇌출혈환자조기혈청CKMB、cTnI화EKG이상개변여병정엄중정도、출혈량대소화출혈부위적관계급기림상의의.방법 선택48례고혈압뇌출혈환자,진행동태GCS평분급CT검사,계산출혈량,판단출혈부위급출혈시부파입뇌실,입원24 h내、72 h、7 d화15 d추신혈측정CKMB、cTnI화심전도검사.결과 고혈압뇌출혈환자재발병24 h내혈청CKMB、cTnI화EKG이상솔분별시12.50%、25.00%화54.17%,72 h이상솔체도고봉,위33.33%、54.17%화77.08%,이후축점하강.발병72 h내유의식장애조CKMB、cTnI화EKG이상솔명현고우무의식장애조,출혈량＞40 ml조명현고우출혈량＜40 ml조,차이유통계학의의;이불동출혈부위화출혈유무파입뇌실조비교,기혈청CK-MB、cTnI화EKG이상솔상근,대비차이무통계학의의.결론 고혈압뇌출혈환자조기보편존재혈청CKMB、cTnI이상승고화심전도이상,기이상여뇌출혈량적대소급병정엄중정도유관,여출혈부위화출혈시부파입뇌실무관.고혈압뇌출혈환자조기진행혈청CKMB、cTnI감측화EKG검사대판단병정적엄중정도유중요적림상의의.
Objective To explore the relations between abnormal changes of CK-MB、cTnI and EKG and severity of illness,volume of blood and bleeding parts at early stage in the patients of hypertensivc cerebral hemorrhage and their clinical significance.Methods 48 patients of hypertensivc cerebral hemorrhage were selected,according to varying GCS scores and CT manifestation,to calculate blood volume,to judge bleeding parts and whether or not bleeding to break into encephalocoele.CK-MB、cTnI and electrocardiogram were observed after 24 h,3days,7 days and 15 days after hospital admission.Results 24 h later the abnormal rates of CK-MB、cTnI and EKG are 12.50%,25.00% and 54.17% respectively,after 3 days they achieve peak,there respectively are 33.33%,54.17% and 77.08%,afterward they gradually degrade.the abnormal rates are higher in the patients who are conscious disturbance and bleeding volume exceeds 400 ml,there are significant differences between conscious disturbance group and no conscious disturbance group( P ＜ 0.05 ),but there are no significant differences in different bleeding parts group and whether or not bleeding breaks into encephalocoele ( P ＞ 0.05 ).Conclusion The abnormal changes of CK-MB、cTnI and EKG are universal in patients of hypertensivc cerebral hemorrhage,they are correlative with severity of illness and volume of blood,but not correlative with bleeding parts and whether or not bleeding breaks into encephalocoele.It has clinical significance to monitor CK-MB、cTnI and EKG in judging severity of illness at early stage in the patients of hypertensive cerebral hemorrhage.
