2003-2012年云南省凤庆县不明原因猝死调查研究  

Investigation of unexplained sudden death clustered in Fengqing,Yunnan,2003-2012

作　　者：赵溯[1] 杨林[1] 王跃兵[1] 罗洪专 雷普平[3] 李加国[1] 马琳[1] 黄文丽[1] 瞿勇强[3] 

机构地区：[1]云南省地方病防治所,云南大理671000 [2]云南省凤庆县疾病预防控制中心,云南凤庆677000 [3]昆明医科大学法医学院,云南昆明650500

出　　处：《疾病监测》2016年第6期512-516,共5页Disease Surveillance

摘　　要：目的调查分析2003 2012年云南省凤庆县某村发生的不明原因猝死事件,为预防、控制类似事件提供借鉴。方法按国家和云南省联合制定的《云南不明原因猝死监测防治方案》进行事件调查和处置,收集流行病学、临床等资料,进行系统尸检、毒(药)物检测和病理研究。结果 2003 2012年,该县的15例不明原因猝死夏季发生于同镇同村委会的两村民小组,共8个无关家庭受累,均为青壮年农民,突然发病、突然死亡,临床表现无特异性;现场调查未能找到毒沟褶菌、毒物和药物等可疑暴露;两户3例尸检未发现相同的病理改变,其中2例多种常规毒(药)物检测阴性,1例毒沟褶菌毒素检测阴性。结论云南省凤庆县某村的不明原因猝死与毒沟褶菌无关,推测经口暴露于小范围内的可疑因素致家庭聚集性猝死。有必要对该村及附近的类似事件开展系统监测,深入调查研究。Objective To understand the epidemiological and clinical characteristics of 15 cases of unexplained sudden death occurred in a village in Fengqing county of Yunnan province from 2003 to 2012,and provide evidence for the prevention and control of such events. Methods The investigation was conducted according to ＂Surveillance,prevention and control protocol of unexplained sudden deaths of Yunnan province＂,in which the clinical and epidemiological data of the death cases were collected,and systematic autopsy,pathological study and poisonous substance detection were performed. Results The15 unexplained sudden cases occurred in 8 families in a village in Fengqing county in summer from 2003- 2012,all the death cases were young adults. The deaths occurred rapidly after sudden onset of illness without specific clinical manifestation,the epidemiological survey didn’t find possible exposures to wild mushrooms,poisonous substances. No consistent pathological changes were found in autopsies of 3 death cases in 2 families,2 death cases were negative for common poisonous substances and 1 death case was negative for toxin of Trogia venenata. Conclusion The 15 unexplained sudden deaths occurred in Fengqing,Yunnan had no relationship with the intake of Trogia venenata,but might be associated with the common oral exposure to the localized risk factor. It is necessary to conduct the systematic surveillance for similar events in this village and nearby areas,and conduct further investigation and research.

关 键 词：猝死 心肌炎 毒沟褶菌 云南省 

分 类 号：R541.78[医药卫生—心血管疾病]