Råsten-Almqvist P, Eksborg S, Rajs J
Department of Forensic Medicine, Karolinska Institute, Stockholm, Sweden.
Acta Paediatr. 2000 Sep;89(9):1062-7. doi: 10.1080/713794581.
Heart and body weights were compared with regard to heart pathology and cause of death in well-defined groups of infants under 1 y of age. In the period 1980 to 1998, out of 468 infants autopsied at the Department of Forensic Medicine in Stockholm, Sweden, 331 died of sudden infant death syndrome (SIDS), while 137 died of other causes. Physical violence was the known cause of death in 30 infants and cardiovascular malformations in another 19. Inflammatory alterations of the myocardium were found in 74 cases (16%): in 17 cases (3.6%) myocarditis was interpreted as the main cause of death; in 45 (10%) it was interpreted as contributing to SIDS and in 12 cases (2.5%) it was observed but judged not to be a contributory cause of death in non-SIDS victims. Two of these infants died as a result of physical violence. Body weight was the best predictor for heart weight as analysed by multiple regression, including age, sex, body weight, length, BMI and birth weight. An equation for estimating heart weight from body weight gave an accuracy within the range 0.75-1.25 in 89.2% and 85.0% of the SIDS and non-SIDS groups, respectively.
Body weight is the best predictor for estimating heart weight. No evidence supported the notion that heart weight, body weight or birth weight of SIDS victims differs from non-SIDS, although heart weight in infants with cardiovascular malformations deviated from observations in the other groups.
对1岁以下明确分组的婴儿,就心脏病理学和死亡原因比较心脏重量与体重。在1980年至1998年期间,在瑞典斯德哥尔摩法医学系进行尸检的468例婴儿中,331例死于婴儿猝死综合征(SIDS),137例死于其他原因。已知30例婴儿的死亡原因是身体暴力,另有19例是心血管畸形。74例(16%)发现心肌有炎症改变:17例(3.6%)心肌炎被认为是主要死亡原因;45例(10%)被认为是导致SIDS的因素;12例(2.5%)观察到有炎症改变,但判断不是非SIDS受害者死亡的促成原因。其中两名婴儿死于身体暴力。通过多元回归分析,包括年龄、性别、体重、身长、体重指数和出生体重,体重是心脏重量的最佳预测指标。根据体重估算心脏重量的方程在SIDS组和非SIDS组中的准确率分别为89.2%和85.0%,范围在0.75 - 1.25之间。
体重是估算心脏重量的最佳预测指标。没有证据支持SIDS受害者的心脏重量、体重或出生体重与非SIDS受害者不同的观点,尽管患有心血管畸形的婴儿的心脏重量与其他组的观察结果不同。