The Retrospective Study Of Cardiac Alternation Concomitant With Acute Cerebral Infarction

ObjectiveThrough retrospective analysis of the clinical data of cardiac alternationconcomitant with acute cerebral infarction, the study obviously discusses theinfluence by atherosclerosis and observes the treatment effect of the medicine namedCreatine Phosphate Sodium for injection. It offers theoretical evidence for theconduction of clinical practice.MethodsIt is a study of retrospective analysis with case-control as the method of thestudy. We selected inpatients suffering from acute cerebral infarction who werehospitalized in department of neurology from December2011to July2013. All theinpatients were examined within7days of the onset of symptoms.Through looking up medical records,(1) according to somatotye of the Trial ofORG10172in Acute Stroke Treatment(TOAST), all the inpatients were divided intotwo groups: atherosclerosis cerebral infarction and non-atherosclerosis cerebralinfarction;(2) according to thre results of electrocardiogram(ECG) and myocardialenzyme spectrum, all the inpatients were divided into two groups again: inpatientswho had cardiac alternation concomitant with acute cerebral infarction and inpatientswho hadn’t cardiac alternation concomitant with acute cerebral infarction.;(3)considering if inpatients take the medicine named Creatine Phosphate Sodium forinjection, the inpatients who had cardiac alternation concomitant with acute cerebralinfarction are subdivided into two groups: the treatment group and the control group.We took notes of results of brain magnetic resonance imaging(MRI)/computedtomography (CT),12-lead ECG, myocardial enzyme spectrum, echocardiography,National Institute of Health Stroke Scale (NIHSS), length of stay and so on. Wefollowed up conditions of patients out of hospital after6months through telephone.We adopt SPSS17.0software to analyze the data.The measurement data is analyzedby t-test. The counting data is analyzed by2test. There is statistical significance onlyif P<0.05. Results1. There were248inpatients in the study，166for male,82for female.The mean of agewas64.70±13.21.173inpatients (69.76%) suffering from acute cerebral infarctionwere examined with cardiac alternation, including153inpatients (61.69%) withabnormal ECG,71inpatients (28.63%) with abnormal myocardial enzyme spectrum.Among abnormal myocardial enzyme spectrum, Creatine kinase isoenzyme-MBmarkedly increase (41.76%).2. There is no statistical difference between inpatients who had atherosclerosiscerebral infarction and inpatients who had non-atherosclerosis cerebral infarctionabout cardiac alternation (69.57%vs70.11%，P=0.86).3. Cardiac alternation concomitant with acute cerebral infarction had intimaterelationship with the lesion location (P=0.00), unrelated with age, sex (P>0.05). Theabnormality of ECG is more common in location of basal ganglia,brainstem,lobe ofbrain,cerebral ganglia. ST-T alternation is the most important performance,sinusarrhythmia is second to it. Among lobe of brain, the incidence rate of cardiacalternation concomitant with acute cerebral infarction in insula is83.33%.4. There is obvious statistical significance between the group in which inpatientssuffering from acute cerebral infarction had abnormal ECG and myocardial enzymespectrum meanwhile and the group in which inpatients suffering from acute cerebralinfarction had normal ECG and myocardial enzyme spectrum about score ofneurological deficits on their admission to hospital(4.96±4.80vs3.04±2.91, P=0.02).The score of neurological deficits on their admission to hospital of the group inwhich inpatients suffering from acute cerebral infarction had abnormal ECG andmyocardial enzyme spectrum meanwhile is higher than the group in which inpatientssuffering from acute cerebral infarction had normal ECG and myocardial enzymespectrum.5. There is no statistical significance between the group in which inpatients hadcardiac alternation concomitant with acute cerebral infarction and the group in whichinpatients hadn’t cardiac alternation concomitant with acute cerebral infarction about Left Ventricular Ejection Fraction of heart (LVEF)(60.86±6.30vs62.31±5.72,P=0.17).6. The result of follow-up study is that mortality rate of the group in which inpatientshad cardiac alternation concomitant with acute cerebral infarction is higher than thatof the group in which inpatiets hadn’t cardiac alternation concomitant with acutecerebral infarction(14.45%vs5.45%).35inpatients were lost(14.11%).7. There is obviously statistical significance between the treatment group and thecontrol group about recovery of neurological deficit (1.88±3.05vs0.68±1.81, P=0.00).The level of recovery of neurological deficit in treatment group is better than that incontrol group.8. There is no statistical significance between teatment group and control group aboutlength of stay in hospital (12.99±5.58vs13.15±9.07, P=0.88).Conclusion1The incidence rate is high because of the cardiac alternation concomitant with acutecerebral infarction. The morality rate of group in which inpatients had cardiacalternation concomitant with acute cerebral infarction is higher than group in whichinpatients hadn’t cardiac alternation concomitant with acute cerebral infarction. Whenthe inpatients suffering from acute cerebral infarction had abnormal ECG andmyocardial enzyme spectrum meanwhile,it can reflex the severity of inpatients’condition. But it doesn’t influence LVEF of heart.2Cardiac alternation concomitant with acute cerebral infarction is related to lesionlocation, but not atherosclerosis,the size of location, age and sex. The abnormality ofECG is more common in location of basal ganglia, brainstem, lobe of brain, cerebralganglia, especially in insula.3On the basis of treatment of cerebral infarction, Creatine Phosphate Sodium forinjection is in favor of improving condition of patients who have cardiacalternation concomitant with acute cerebral infarction.