53例心原性猝死的临床病理分析  

Clinical Pathological Analysis of Sudden Cardiac Death in 53 cases

作　　者：曹素艳[1] 邓开伯[1] 林凤茹[1] 

机构地区：[1]卫生部北京医院

出　　处：《中国心血管杂志》1999年第3期156-158,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的 探讨心原性猝死(SCD)的临床特点、病理基础及致死因素,为防治SCD提供线索.方法 回顾性分析我院53例SCD的临床病理资料.结果 53例SCD患者中,冠心病猝死36例,主动脉夹层动脉瘤破裂者7例,心肌炎7例,心肌病3例.冠心病猝死36例中,陈旧性心肌梗塞(OMI)23例,其中合并急性心肌梗塞(AMI)18例,单纯AMI7例(致心脏破裂4例),心肌缺血6例.尸检发现冠状动脉粥样硬化性狭窄Ⅳ级31例,呈多支Ⅳ级病变者24例.结论　SCD病程短骤、凶险,以老年男性多见,冠心病占首位.其次为主动脉夹层动脉瘤破裂、心肌炎、心肌病.冠状动脉多支重度粥样硬化性狭窄是重要的病理基础.尽早防治冠心病,改善心肌供血是预防SCD的根本措施.长期监测动脉瘤的发展而对有增大或濒临破裂征象者立即手术,也是减少SCD的有效措施.SCD随时随地可以发生,因此普及现场心肺复苏抢救知识及建立完善急救系统十分必要.Objective To investigate the clinical features,the pathological bases and the causes of sudden cardiac death (SCD). To provide the clues of preventing and treating SCD. Methods Retrospectively analyzed the clinical and pathological material of SCD in 53 cases in our hospital. Results 36 cases died of coronary atherosclerotic heart disease, of which,old myocardial infarction (OMI) was found in 23 cases,and it was combined with acute myocardial infarction (AMI) in 18 cases,simple AMI in 7 cases (4 cases died of cardiac rupture),myocardial ischemia in 6 cases. There were atherosclerotic stenosis (grade 4) of the coronary artery in 31 autoptic cases,of which 24 cases were with multiple branches involvement. The other causes of SCD were found:ruptured aortic interlamellar aneurysm in 7 cases, myocarditis in 7 cases and myocardiosis in 3 cases. Conclusion Urgent and dangerous SCD is,frequently attack the older men. The first cause of SCD is considered as coronary atherosclerotic heart disease,then the ruptured aortic interlamellar aneurysm, myocarditis and myocardiosis. Severe multiple branches atherosclerotic stenosis of the coronary artery is considered as one of the important pathological bases of SCD. The foundation measure of preventing SCD is preventing and treating coronary heart disease early, and improving myocardial circulation. The effective measures to reduce SCD include long -term following up the aortic aneurysmal patients and operating those aneurysm enlarged on the edge of rupture. As SCD can occur any time,it is necessary to popularize the knowledge of emergency treatment and resuscitation on the spot,and to organize the effective emergency system.

关 键 词：SCD 心原性猝死 临床病理分析 病理基础 狭窄 心肌病 主动脉夹层动脉瘤 目的 结论 方法 

分 类 号：R541[医药卫生—心血管疾病] R744[医药卫生—内科学]