除了心电图中的心律失常:QT间隔和中风亚型和严重程度之间是否存在任何相关性?
Jayakumari Nandana1, Arun Gopalakrishnan2, Sajith Sukumaran1
1Comprehensive Centre for Stroke Care, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India.
概括
长时间纠正的QT (QTc) 间隔在急性缺血性中风 (AIS) 中很常见. 在48小时内持续延长的QTc表明患者的治疗结果较差,突出显示中风恢复中的脑心轴.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 自主神经系统研究 自主神经系统研究
背景情况:
- 电脑心电图上的QT间隔对自主变化敏感,这种变化在急性缺血性中风 (AIS) 中很常见.
- 有限的研究存在于AIS亚型如何差异影响QT间隔.
- 之前的研究指出,缺血性和出血性中风之间的QT间隔变化.
研究的目的:
- 为了确定AIS患者中QT间隔异常的发生率.
- 调查QT间异常,中风严重程度和中风亚型之间的关联.
- 在AIS中探索QT间隔延长的预后价值.
主要方法:
- 一项前性,单中心的观察性研究包括100名AIS患者.
- 从心电图收集了关于临床特征,中风严重程度 (NIHSS),残疾 (mRS),中风亚型 (TOAST) 和修正的QT (QTc) 间隔的数据.
- 在入院时分析QTc间隔,48小时,入院后3个月.
主要成果:
- 59%的患者在入院时表现出QTc延长,在48小时后降至40%,在3个月后降至15%.
- QTc延长与中度至严重的中风,严重残疾 (mRS 3-6) 和大动脉动脉样硬化显著相关.
- 在48小时持续延长的QTc与更严重的神经缺陷 (NIHSS) 和残疾 (mRS) 在出院和3个月的随访相关.
结论:
- 在AIS患者中,QTc延长是常见的发现.
- 治疗后48小时持续的QTc延长是较差临床结果的预测因素.
- 由大脑-心轴和中风特征影响的可变自主调节障碍可能导致AIS中的QTc异常.
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