70例心脏性猝死患者的临床尸检病理分析  

Clinical pathological analysis of sudden cardiac death in 70 patients

作　　者：曹素艳[1] 沈瑾[1] 马正中[1] 

机构地区：[1]卫生部北京医院急诊科,北京100730

出　　处：《中华急诊医学杂志》2005年第6期504-506,共3页Chinese Journal of Emergency Medicine

摘　　要：目的探讨心脏性猝死(SCD)的临床特点、病理基础及致死因素,从而为防治SCD提出有效措施。方法回顾性分析我院70例SCD的临床尸检病理资料。结果70例SCD患者中,冠心病猝死43例,主动脉夹层动脉瘤破裂者13例,心肌炎6例,心肌病3例,肺栓塞5例。冠心病猝死43例中,陈旧性心肌梗死(OMI)7例,OMI+急性心肌梗死(AMI)27例,单纯AMI7例。尸检发现冠状动脉粥样硬化Ⅳ级狭窄者33例,其中多支病变者36例。结论SCD病程短骤、凶险,以老年男性多见,冠心病占首位。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、高血压,改善心肌供血是预防SCD的根本措施。Objective To investigate the clinical features, pathological bases and causes of sudden cardiac death (SCD),and to provide the preventive treatment of SCD. Methods The clinical and pathological materials of SCD in 70 patients in our hospital Emergency Medicine Repartment,were retrospectively analyzed. Results Forty-three cases died of coronary atherosclerotic heart disease.Among them, old myocardial infarction (OMI) was found in 7, and combined with acute myocardial infarction (AMI) in 27 cases, simple AMI was found in 7 cases. There was atherosclerotic stenosis (grade 4) of the coronary artery in 33 autoptsy cases, of whom 36 patients had multiple branches involvement. The other causes of SCD found were: ruptured aortic interlamellar aneurysm in 13 patients, myocarditis in 6 and myocardiosis in 3,acute pulmonary embolism in 5 cases. Conclusion Sudden and dangerous SCD frequently attacked the older patients. The first cause of SCD was coronary atherosclerotic heart disease. The foundation measure to prevent SCD is preventing and treating coronary heart disease early, and improving myocardial circulation.

关 键 词：心脏性猝死 病理分析 尸检 患者 主动脉夹层动脉瘤破裂 冠状动脉粥样硬化 陈旧性心肌梗死 冠心病猝死 急性心肌梗死 病理基础 SCD 回顾性分析 硬化性狭窄 临床特点 致死因素 病理资料 多支病变 老年男性 心肌供血 心肌炎 

分 类 号：R541[医药卫生—心血管疾病] R361.1[医药卫生—内科学]