Clinical Classification Of Acute Cerebral Infarction And Analysis Of Electrocardiogram And Myocardial Markers

Objective: To explore the abnormal rule of ECG and myocardial injury markers of different clinical types of acute cerebral infarction,and further analyze the risk factors and prognosis of cerebral infarction complicated with cerebro-cardiac syndrome(CCS).It can provide positive guidance for clinical prevention,diagnosis and prognosis of cerebro-cardiac syndrome.Methods: In this study,171 patients with acute cerebral infarction who were admitted to the department of neurology,affiliated to yijishan hospital of WanNan Medical College from September 2017 to December 2018 were collected in strict accordance with the inclusion and exclusion criteria.Baseline data were collected for all patients after admission(including name,age,smoking and drinking history,admission and discharge NIHSS score,presence or absence of hypertension,diabetes,and dyslipidemia).The OCSP typing of cerebral infarction and routine 12-lead electrocardiogram examination were completed on the day of admission.Venous blood of 5ml was collected in the morning of the second day of admission,and the values of CK-MB,cTnI and BNP were determined by double-antibody sandwich enzyme-coupled immunosorbent assay(Elisa)in the clinical laboratory of the hospital.All abnormal patients were reexamined after 7 days.Statistical analysis was performed on all collected data.Results: 1.The overall accuracy of OCSP typing of acute cerebral infarction was84.21%,82.82% in TACI group,86.79% in PACI group,83.33% in POCI group and84.21% in LACI group.The difference between OCSP typing and magnetic resonance typing of cerebral infarction was not significant after statistical analysis(P>0.05).2.In this study,96 of the 171 patients with acute cerebral infarction had cerebro-cardiac syndrome,and the incidence of CCS was 56.14%.The incidence of CCS in each group was as follows: 84.10% in the TACI group,56.60% in the PACI group,55.56% in the POCI group,and 23.68% in the LACI group.The difference in the incidence rate of each group was statistically significant(P<0.001).3.The ECG abnormality rate of acute cerebral infarction was 52.05%,with the highest rate in TACI group,followed by PACI group and POCI group,and the lowest rate in LACI group.The rate of myocardial ischemia(ST-T change)in TACI group,PACI group and POCI group was higher than that in LACI group(P<0.05).The ratio difference between TACI group and LACI group in arrhythmia and left ventricular high voltage was considered statistically significant(P<0.05).4.The abnormal rate of myocardial markers in acute cerebral infarction was 28.07%,and further statistics showed that the abnormal rate of ck-mb was 14.04%,the abnormal rate of cTnI was 12.87%,and the abnormal rate of BNP was 23.98%.The abnormal rate of myocardial markers in TACI group was significantly higher than that in LACI group(P<0.05),and there was no significant difference in the abnormal rate of myocardial markers between the other two groups(P>0.05).The difference of CK-MB,cTnI,BNP in TACI group and LACI group was statistically significant(P<0.05).The cTnI abnormality rate in PACI group was higher than that in LACI group(P<0.05).5.Correlation analysis of acute cerebral infarction complicated with cerebro-cardiac syndrome and various risk factors,showed that the differences of admission NIHSS score,hypertension and hyperlipidemia in whether cerebral infarction complicated with cerebro-cardiact syndrome were statistically significant(all P<0.05).6.The NIHSS score of discharge in the group with cerebral infarction combined with CCS was 33.33%(23.61%)lower than that of admission,while the NIHSS score of discharge in the group without CCS was 50%(75%)lower than that of admission.The difference in prognosis between the two groups was statistically significant(P<0.05).Conclusions: 1.The incidence of cerebro-cardiac syndrome was the highest in TACI group,followed by PACI group and POCI group,and the lowest in LACI group.2.The ECG abnormality rate was the highest in TACI group,followed by PACI group and POCI group,and the lowest in LACI group.3.The abnormal rate of myocardial markers in TACI group was significantly higher than that in LACI group,and there was no significant difference in the abnormal rate of myocardial markers between the other two groups.4.The admission of patients with cerebral infarction with high NIHSS score,previous history of hypertension,and history of hyperlipidemia are all risk factors for cerebro-cardiac syndrome.5.Acute cerebral infarction complicated with cerebro-cardiac syndrome will adversely affect the prognosis of patients.