云南省116例不明原因猝死回顾性研究  

Retrospective study on 116 unexpected sudden cardiac deaths in Yunnan,China

作　　者：施国庆[1] 张健[2] 黄文丽[3] 杨涛[1] 叶绍东[2] 孙晓冬[1] 李兆祥[3] 解晓华[1] 李芙蓉[1] 王跃兵[3] 任金马[1] Robert E.Fontaine 曾光[1] 

机构地区：[1]中国疾病预防控制中心中国现场流行病学培训项目,北京100050 [2]中国医学科学院阜外心血管病医院 [3]云南省地方病防治所

出　　处：《中华流行病学杂志》2006年第2期96-101,共6页Chinese Journal of Epidemiology

基　　金：科技部国家重大科技攻关资助项目(2003BA712A11-01)

摘　　要：目的了解云南省不明原因猝死流行病学和临床特征.方法选择祥云、鹤庆、南涧和大姚4个县既往不明原因猝死病例作为调查对象.采用统一调查表,调查猝死者家庭成员、见证人和诊治医生,查阅诊治记录,收集病例信息.结果1984-2004年,21个自然村发生116例不明原因猝死;7月和8月病例分别占66%和29%,10～39岁年龄组发生率（1.6/1000）高于其他年龄组（x^2=16,P〈0.01）,女性高于男性（RR=1.6,95%CI：1.1～2.3）;70%为家庭聚集性病例,61%家庭续发猝死发生在首例猝死后的24小时内（中位数20小时）;63%病例死亡前主诉头晕、头昏、恶心、昏迷、晕厥、乏力、心悸等症状,急性发病至死亡时间中位数2小时.结论云南省不明原因猝死有明显的空间和时间聚集性,表明危险因素在特定条件下存在;家庭猝死集中,提示同源暴露;急性发病表现为心源性疾病症状,死亡突然.Objective To identify the epidemiological and clinical features of unexpected sudden cardiac deaths （SUD） in Yunnan. Methods Choosing the old SUD cases from Xiangyun, Heqing, Nanjian and Dayao counties and using the standardized verbal autopsy Form, we interviewed the family members of the cases, witnesses and doctors as well as reviewing their medical files to get relative information. Results We identified 116 SUDs in 21 villages from 1984 to 2004. The village-specific annually standardized incidence rates were ranged from 0.2] 1000 to 8.9] 1000 （median= 0.8] 1000）. 66 % and 29% of the SUDs occurred in July aud August respectively. The incidence rates of SUD were higher （1.611000, x^2= 16, P〈 0.01） in 10-39 year-olds, and higher in females than in males （RR= 1.6, 95 % CI：1. 1-2.3）. Seventy percent of SUD occurred in families having clustering nature and 60 % of the additional cases in the family were occurred within 24 hours （median = 20 hours） after the first SUD identified in the family. SUD occurred in 23 families followed the first affected family in a village during the same season. In these 23 families, 61% of the first SUD occurred within 8 days after the first SLID in the first affected family. 68 % and 66 % of the SUDs did not have any complaints or signs during the last 3 weeks or from 3 weeks to 2 days prior to the onset of the disease. 63 % of the SUDs had cardiac symptoms within the last 2 days prior to the onset with major symptoms as dizziness, nausea, faintness, , weakness and palpitation. The median duration from acute onset to death was 2 hours Conclusions The extreme time-space clustering of SUD in families and in villages suggested that the risk factors occurred in specific time and location. Familial clusterred SUD cases had common exposure pattern. Sudden onset of acute cardiac symptoms often followed by sudden death. Epidemiological study on new cases was necessary to identify risk factors and to develop hypothesis for causation. In July 2005, we instituted a speci

关 键 词：不明原因猝死 家庭聚集性 心源性疾病 

分 类 号：R181.3[医药卫生—流行病学]