Glasgow coma score combined with optic nerve sheath diameter in predicting the risk of death from cerebrocardiac syndrome / 中华急诊医学杂志

Objective:To explore the value of Glasgow coma score (GCS) combined with optic nerve sheath diameter (ONSD) in predicting the death risk of patients with cerebrocardiac syndrome (CCS).Methods:From January 2021 to September 2021, 83 patients with CCS secondary to severe traumatic brain injury (sTBI) in our hospital were collected and divided into a survival group ( n = 37) and death group ( n = 46) according to CCS-related death. The clinical data including age, sex, underlying diseases, head CT imaging manifestations, electrolytes, blood glucose, C-reactive protein (CRP), neuron-specific enolase (NSE), lactate dehydrogenase (LDH), creatine kinase (CK), creatine phosphokinase isoenzyme (CKMB), intracranial pressure (ICP), ONSD, cardiac color ultrasound, acute physiology and chronic health evaluationII (APACHEⅡ ) and GCS were analyzed and compared between the two groups. The proportion and dosage of vasoactive drugs used at admission, daily fluid balance volume during hospitalization, total amount of sedative and analgesic drugs, and average daily dose were analyzed and compared between the two groups. The independent risk factors for CCS-related death were analyzed using multivariate logistic regression. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of the independent risk factors in CCS-related death. Results:In this study, 55.4% of the patients died of CCS. The ONSD, ICP change rate, right ventricular Tei index and NSE in the death group were higher than those in the survival group, with statistically significant differences ( P < 0.05), while the GCS in the death group was significantly lower than that in the survival group, with a statistically significant difference ( P < 0.01). ONSD ( OR = 23.890, 95% CI: 5.526-103.286, P < 0.001), GCS ( OR = 17.066, 95% CI: 1.476-197.370, P = 0.023) and ICP change rate ( OR = 0.060, 95% CI: 0.007-0.477, P = 0.008) were the independent risk factors for CCS-related death. The area under the ROC curve (AUC = 0.897) of ONSD combined with GCS in evaluating CCS-related death was larger than that of ONSD, ICP change rate alone and the corresponding AUC of 1/GCS (0.876, 0.785, 0.800, respectively), with the advantages of non-invasive, dynamic monitoring and low inspection costs. Conclusions:The mortality rate of CCS is high. ONSD, GCS and ICP change rates are independently correlated with the death of CCS patients. ONSD combined with GCS is an ideal indicator for clinical prediction of CCS-related death.

Clinical characteristics of severe acute spontaneous subarachnoid hemorrhage complicated by cerebrocardiac syndrome / 中华神经医学杂志

Objective To explore the electrocardiogram (ECG) characteristics and prognoses of patients with severe acute spontaneous subarachnoid hemorrhage (SAH) complicated by cerebrocardiac syndrome (CCS).Methods The ECG characteristics and clinical data of 80 patients with severe SAH admitted to our hospital from January 2012 to December 2015 were retrospectively analyzed.The myocardial enzymes,serum troponin T and ECG changes in patients of Hunt-Hess grading Ⅳ and Ⅴ were compared.Results ECG abnormalities at the first time were noted in 76 patients,accounting for 95％.Wave changes (more than two kinds) were noted in 63 patients.ST-T changes were noted in 68 patients,T wave changes in 45,QT interval prolongation in 30,cardiac arrhythmia in 26,conduction block in 11,and abnormal Q wave in 9.The occurrence rates of Q-T interval prolongation,cardiac arrhythmia,conduction block,abnormal Q wave and Glasgow outcome scale (GOS) scores between patients of Hunt-Hess grading Ⅳ and Ⅴ were significantly different (P＜0.05).The myocardial enzyme levels were normal and serum troponin T level slightly increased in patients of Hunt-Hess grading Ⅴ within 2 h of admission.Conclusion ST and T waves changes are the common electrocardiogram manifestations of acute severe SAH patients with CCS;CCS is the important prognostic factors of acute severe SAH patients.

Clinical Observation of Shensong Yangxin Capsules in the Treatment of Brainstem Hemorrhage Complicat-ed with Cerebrocardiac Syndrome Accompanied by Arrhythmia / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of Shensong yangxin capsules in the treatment of brainsten hemorrhage complicated with cerebrocardiac syndrome(CCS)accompanied by arrhythmia. METHODS:Medical information of 98 patients with brainstem hemorrhage complicated with CCS arrhythmia were analyzed retrospectively and divided into control group (49 cases)and observation group(49 cases)according to drug use. Control group was given routine treatment as mannitol and pi-racetam. Observation group was additionally given Shensong yangxin capsules 1.2 g orally or via nasal feeding,3 times a day,on the basis of control group. Treatment course of 2 groups lasted for 4 weeks. Clinical efficacies of 2 groups were observed as well as the levels of catecholamine [norepinephrine(NE),epinephrine(E),dopamine(DA)],ET-1 and NO,the occurrence of ADR be-fore and after treatment. RESULTS:Total response rate of observation group was significantly higher than that of control group (75.5% vs. 46.93%),with statistical significance(P0.05). 3 and 7 d after treatment,the levels of NE,E,DA,ET-1 and NO in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statisti-cal significance(P0.05). CONCLU-SIONS:Based on routine treatment,Shensong yangxin capsules shows significant therapeutic efficacy for CCS,can reduce levels of catecholamine and doesn't increase the occurrence of ADR.

Correlation analysis of occurrence and its prognosis of cerebrocardiac syndrome in critically neurosurgery patients / 重庆医学

Objective To investigate the correlation between the cerebrocardiac syndrome (CCS) of severe type and prediction of prognosis of patients with neurosurgery .Methods Myocardial zymogram levels were measured in course of development of 120 ca‐ses of Acute Stroke(AS) that were confirmed diagnosis by brain computerized tomography (CT) .ultrasoundcardiogram(UCG)and electrocardiogram(ECG)were used to dectect Segmental Wall Motio Abnormalities (SWMA) .Results For 120 patients with AS , the specimens include 38 cases(76 .0% )of T‐wave change and 12 cases(24 .0% )of ST‐segment depression in 50 cases of ST‐T seg‐ment change ,7 cases of arrhythmia and adnormal cardiac electrical conduction .24 cases of SWM A ,32 cases(26 .7% ) of raised CK‐MB ,35 patients could be recovered to normal of ECG after active treatment .17cases of ECG improve markedly ,18 cases of ECG un‐improved ,15 cases of myocardial enzymes normally ,8 cases of myocardial enzymes improve markedly20 cases of death .Conclusion Hypertension is a risk factor of CCS ,correlation between ST‐T segment and SWMA as well as myocardial enzymes and myocardial damagein CCS was statistically analyed .

Establishment of cerebrocardiac syndrome model in rats / 中国药理学通报

Aim To establish cerebrocardiac syndrome model in rats. Methods Right middle cerebral artery of rat was occluded (MCAO) with nylon thread and Ⅱ lead ECG was monitored continuously within 2 h to record the emerging of arrhythmias. 30 min, 2 h, 24 h after middle cerebral artery occlusion or 6 h reperfusion after 2 h occlusion, left ventricular myocardiums were observed with transmission electron microscope to find the morphological damage and brains were marked with TTC to locate infarction area. Results (14.9?11.4) minutes after MCAO, 71%(60/85)model rats had abnormal ECG changes including 38 %(32/85)premature ventricular contraction, 27 %(23/85)atrial premature beats, 5%(4/85)ventricular tachycardia, 1.2%(1/85)sinus tachycardia. Arrhythmias sustained (29.0?23.2 )minutes. Ventricular myocardial cell injury was obvious: chaotic and broken mitochondria ridges, aggregated chromatin under the nucleus membrane, deposited glycogen granules in the cytoplasma. 30 min, 2h, 24h after MCAO the infarction rates were 8.7%?1.1%,11.4%?2.3% and 13.7%?3.1% respectively. Conclusion A stable cerebrocardiac syndrome model in rat might be induced by means of occluding right middle cerebral artery and the morphological bases of cerebrogenic cardiac arrhythmias are myocardial cell injury caused by cerebral infarction.

The heart function change in patients with acute cerebral hemorrhage / 重庆医科大学学报

Objective:To get the message ofthe cardiac dysfunction arises from the cerebral hemorrhage in CH patients by investigate the relationship among the Electrocardiographic abnormalities、the hemorrhagic location、the cerebral lesion degree and the outcome.Methods:Analysis the ECG of the 304 acute hemorrhagic stroke patients who made the final diagnosis by CT,without the history of heart disease.Results:There are evident change of the ECG in acute hemorrhagic stroke patients,the total incidence rate reach up to 67.1%(204/304),and these change keep close tothe cerebral lesion location that different fromthe relation between themand the cerebral lesion degree and link with the prognosis with the cerebral lesion degree,P