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目的 了解急性脑出血对心脏自主神经活性改变、心电图复极改变和心律失常的影响。方法 检测61例急性大脑半球壳核和额顶颞叶出血患者和39例对照的24 h动态心电图,分析其心率变异性变化、心电图复极改变和心律失常。结果 右侧壳核和额顶颞叶出血患者急性期室上性快速心律失常和心房颤动发生率明显增高;左侧壳核和额顶颞叶出血患者急性期心电图ST段降低发生率明显增高。右侧壳核和额顶颞叶出血组心率变异性指标HF、RMSSD、PNN50明显下降和LF/HF明显增高。伴室上性快速心律失常者LF/HF高于无室上性快速心律失常者,HF明显低于无室上性快速心律失常者。结论 左侧和右侧大脑半球出血对心脏的影响不同,岛叶病变在其中起着主要作用。
Objective To investigate the effects of acute cerebral hemorrhage on cardiac autonomic nerve activity changes, electrocardiographic repolarization changes and arrhythmia. Methods Twenty-six cases of acute cerebral hemispheric putamen and frontotemporal temporal lobe hemorrhage and 39 controls were examined by 24-hour dynamic electrocardiogram. The changes of heart rate variability, electrocardiographic repolarization and arrhythmia were analyzed. Results The incidence of acute supraventricular tachyarrhythmias and atrial fibrillation in the right putamen and frontal temporal lobe hemorrhage patients was significantly higher than that in the control group. The incidence of ST segment depression in the acute phase of the left putamen and frontal temporal lobe hemorrhage was significantly increased. Right heart and frontal temporal lobe hemorrhage group heart rate variability indicators HF, RMSSD, PNN50 decreased significantly and LF / HF was significantly higher. LF / HF with supraventricular tachyarrhythmia was higher than those without ventricular tachyarrhythmias, and HF was significantly lower than those without ventricular tachyarrhythmias. Conclusion The left hemisphere and the right hemisphere hemisphere have different effects on the heart. Island lesion plays a major role.