摘要目的 分析老年急性缺血性梗死(CIS)患者伴有缺血性ST-T改变的心电图(ECG)特征,并进一步分析ST-T改变与老年CIS病情严重程度之间的关系.方法 选择本院2016年5月至2018年5月收治的120例老年CIS患者,根据有无缺血性ST-T改变分为持续性缺血ST-T改变组(27例)、短暂性缺血ST-T改变组(52例)和无缺血性ST-T改变组(41例),分析患者的ECG特征,比较3组患者在不同病情下的ECG异常发生率,并分析其与病情严重程度、梗死灶大小及预后的关系.结果 入院时ECG检查主要表现为缺血性ST-T改变79例(65.83％),其次为心率失常48例(40.00％),且患者可并发1项或多项ECG异常.入院时3组患者ECG表现与病情严重程度比较差异有统计学意义(P<0.05).入院时3组患者梗死灶大小比较差异有统计学意义(P<0.05).治疗21 d后3组患者预后比较差异有统计学意义(P<0.05).结论 缺血性ST-T改变在老年CIS的病情评估及预后判断中具有一定的临床参考价值,可用于指导患者治疗.

abstractsObjective To analyze the characteristics of electrocardiogram (ECG) in elderly patients with acute cerebral ischemic stroke (CIS) and ischemic ST-T change, and further analyze the relationship between ST-T dynamic changes and the severity of disease in elderly CIS patients. Methods 120 cases of elderly patients with acute CIS treated in our hospital from May 2016 to May 2018 were enrolled, and were divided into continuous ischemic ST-T change group (27 cases), transient ischemic ST-T change group (52 cases), and non-ischemic ST-T change group (41 cases). The ECG features were analyzed, the incidences of ECG abnormalities among three groups of patients were compared respectively, and finally the relationship between the incidences and the severity of disease, infarct size, and prognosis were analyzed. Results On admission, ECG examination of 79 patients manifested as ischemic ST-T change (65.83％), then 48 patients manifested as arrhythmia (40.00％), and patients were complicated by 1 or multiple ECG abnormalities. The differences of the severity of disease and features of ECG among three groups of patients were statistically significant (P<0.05), the infarct size was significantly different among 3 groups of patients (P<0.05), and the prognosis after 21-day treatment among 3 groups of patients were significantly different (P<0.05). Conclusion Ischemic ST-T change has the certain clinical reference value in diagnosing the severity of disease and prognosis among elderly patients with acute CIS, which can be used to guide the treatment.