致命性冠心病的死亡原因──100例临床病理分析  

The Fatal Cause of Lethal Coronary Heart Disease-Clinical Pathological Analysis of 100 Cases

作　　者：丁自超[1] 祝庆孚[2] 曾木英[2] 王锦传[3] 

机构地区：[1]解放军总医院急诊科,北京100853 [2]解放军总医院病理科,北京100853 [3]解放军总医院医学统计室,北京100853

出　　处：《急诊医学》1994年第3期67-72,共6页

摘　　要：从冠心病为死亡主要或重要原因100例的尸解所见，冠状动脉粥样硬化在冠脉主支有≥Ⅲ级者占98％，多个主支有≥Ⅲ级者70％，主支有完全或几乎完全阻塞性病变者35％。单纯AMI者18％，兼有AMI与OMI51％，急性缺血性心肌病变6％；多处心梗病变者85％。25例发生心室壁瘤，14例发生心脏破裂。经统计学处理死亡原因居首位为急性左心衰竭（含泵衰竭）占85％；第二位为严重心律失常40％（含猝死为55％）、心源性休克42％（含泵衰竭38％）、呼吸衰竭31％；第三位为心脏破裂14％与多脏衰16％，三者间有很显著差异（P＜0．01）。严重心律失常及猝死在院前及发病早期占死亡原因的首位。针对以上分析，提出相应的防治意见。A clinical -pathological analysis of 100 cases on the lethal cause of fatal coronary heart bisease was made.Autopsy findings: 1. coronary atheroscherosis with lesions on main branches of coronary arteries,≥3 degree in 98 cases,or 98%;complete obstruction occured in≥1 main branch,in 35 cases,or 35%. 2. myocardial lesions. in AMI 30 cases,or 30%;OMI 18 cases or 18%,both AMI & OMI lesions 51 cases, 51%,acute ischemic lesion 6 cases,or 6%. 3. the location of myocardial infarction:more than 2 places 85 cases,or 85%. 4. cardiac. ventricular aneurysms occured in 25 cases, with 27 aneurysms; and cardiac rupture in 14 cases,5 of them with aneurysms.Clinical pathological analysis of fatal causes: sudden death 15 cases and 12 among which occured before coming to the hospital or death in emergency room. From statistics showed that the lst Iethal cause was acute left ventricular failure (including acute pulmonary edema) in 85%. The second cause was cardiogenic shock (including pump failure) in 42 %,and severe arrhythmias in 40% (including sudden death in 55%) & pulmonary failure in 31%.They showed significant differences (p<0. 05).The third cause was multiple organs failure in 16% & cardiac rupture in 14%. aiming at these causes, 11 measures of monitoring &therapy were raised.

关 键 词：致命性 冠心病 死亡原因 

分 类 号：R541.402[医药卫生—心血管疾病]