Retrospective Analysis Of Acute Cerebral Infarction And Cerebro-Cardiac Syndrome

Objective:Acute cerebral infarction is a common disease in neurology department,with the characteristics of high incidence,high morbidity,high mortality and high recurrence rate.In recent years,the incidence of ischemic stroke gradually increased and tended to be younger,furthermore while acute cerebral vascular disease prone to cerebro-cardiac syndrome,not only to further complicate the patient’s condition,but also lead to increased mortality.In this paper,we focused on the narrow sense of the cerebro-cardiac syndrome,only the patients with acute cerebral infarction in our hospital were collected and analyzed retrospectively,we summarized the incidence,occurrence time,location and electrocardiogram,myocardial enzyme changes,to explore the pathogenesis,clinical characteristics and preventive measures of cerebral cardiac syndrome.On the one hand,to provide guidance for clinical work,consider the overall condition of patients,so as to reduce the mortality of patients,improve the quality of life of patients;in addition,to provide prescient reference for further research of acute cerebral infarction even various brain diseases with cerebral cardiac syndrome.Methods:We collected 122 cases of acute cerebral infarction in our hospital neurology department from December 2014 to December 2016.All patients were examined within 2 days with the head CT or MRI.The diagnostic criteria of acute cerebral infarction in accordance with the Fourth National Association of cerebrovascular diseases.When the patient was admitted to the hospital,to carry on the chest 12 lead ECG,on admission or admission the next morning to extract 5ml venous blood,carry on the myocardial enzyme examination.Determination of the enzyme indicators include: brain natriuretic peptide,cardiac troponin I,myoglobin,creatine kinase and creatine kinase isoenzyme,lactate dehydrogenase,aspartate aminotransferase,abnormal intervals were given corresponding review.According to inclusion and exclusion criteria,all cases were strictly screened.According to the location divided all into lobar group,radiation crown group,basal ganglia group,brainstem group,cerebellum group.The changes of ECG and myocardial enzymes of all were analyzed.All data were used SPSS17.0 statistical software for processing,measurement data using `x±s,count data by percentage(%),compared with c2 test,P < 0.05,the difference was statistically significant.Results:(1)In this study,122 cases of acute cerebral infarction in patients with abnormal ECG in 63 cases,the incidence of cerebro-cardiac syndrome was 51.64%.Lobes,radiation crown,basal ganglia,brainstem and cerebellum group,the combination of cerebro-cardiac syndrome incidence were: 29.03%,41.17%,65.11%,68.75%,53.33%.Basal ganglia,brainstem infarction and cerebro-cardiac syndrome was significantly higher than that of cerebral lobe infarction(basal ganglia group compared with lobes group: c2=9.382,P=0.002<0.05;brainstem group compared with lobes group: c2=6.810,P=0.009<0.05),there were statistically significant difference.(2)The changes of ECG were characterized by myocardial ischemia,mainly ST-T,followed by arrhythmia;atrial fibrillation was the main cause of the change of ECG in the lobes of cerebral infarction,in multi lobes or large area(especially combined with temporal lobe and insula infarction)was more obvious,one or more of the ECG changes can occur in the same patient.(3)There were 25 cases of abnormal myocardial enzyme in the patients of 122 cases,there may be one or several changes of myocardial enzymes in the same patient,accompanied by changes in ECG.Abnormal myocardial enzymes were found in 72 h,in particular,the change of brain natriuretic peptide was the most obvious and the longest duration,which could be abnormal in a few hours after cerebral infarction,even earlier than ECG changes,the incidence rate of basal ganglia infarction was the highest,accounting for 48%.Conclusion:1.Acute cerebral infarction complicated with cerebro-cardiac syndrome was more common in the middle areas of basal ganglia and brainstem.2.The myocardial ischemic incidence in acute cerebral infarction complicated with cerebro-cardiac syndrome were higher,atrial fibrillation in multi lobe or large area infarction was more obvious.3.During this study,the changes of myocardial enzymes in patients with acute cerebral infarction were mostly seen in brain natriuretic peptide,and the rate of basal ganglia infarction was the highest.