Department of Pediatrics, Thomas P. Graham Jr Division of Cardiology, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University School of Medicine, Nashville, Tennessee 37232-9119, USA.
Curr Opin Pediatr. 2012 Oct;24(5):592-602. doi: 10.1097/MOP.0b013e328357a7c3.
Sudden death is a leading cause of death in industrialized nations. Sudden death in children represents a relatively small proportion of sudden death in the population, but has devastating effects on families and communities, and often attracts significant attention.
Several recent studies show that a portion of previously unexplained sudden death in children is due to cardiac conditions which are potentially identifiable by 'molecular autopsy' or investigation of family members. As some of these conditions that may present with sudden death can be detected by ECG, the controversial role of screening asymptomatic children will be discussed, as will the question of increased risk associated with stimulant medications. Recent pharmacologic and nonpharmacologic advancements for those with identifiable conditions at increased risk of sudden death will be reviewed.
Recent developments have refined our understanding of the various causes of sudden death in children. Post-mortem genetic testing and/or investigation of family members can be fruitful in determining a cause and identifying at-risk relatives. Given the available and potential treatments for specific disorders with increased risk of sudden death, the benefit of identifying such disorders early is clear. The debate regarding universal ECG screening is social and political, as well as scientific.
猝死是工业化国家的主要死亡原因。儿童猝死在人群中的比例相对较小，但对家庭和社区有毁灭性的影响，通常会引起广泛关注。
几项最近的研究表明，以前无法解释的部分儿童猝死是由于心脏疾病引起的，这些疾病可以通过“分子尸检”或对家庭成员进行调查来确定。由于一些可能导致猝死的疾病可以通过心电图检测到，因此将讨论对无症状儿童进行筛查的争议性问题，以及与兴奋剂药物相关的风险增加问题。还将回顾那些有明确猝死风险的可识别疾病患者的最新药物和非药物治疗进展。
最近的研究进展使我们对儿童猝死的各种原因有了更深入的了解。尸检后的基因检测和/或对家庭成员的调查可以有效地确定病因并识别高危亲属。鉴于特定具有增加猝死风险的疾病有可用的和潜在的治疗方法，早期发现这些疾病的好处是显而易见的。关于普遍进行心电图筛查的争论不仅是科学的，也是社会和政治的。
