Chen Yuanyuan, Zhang Fu, Yan Yanan, Wang Shiquan, Zhang Le, Yan Fengping
Department of Forensic Medicine, School of Basic Medical Sciences, Gannan Medical University, Ganzhou, China.
Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Disease of Ministry of Education, Gannan Medical University, Ganzhou, China.
Front Psychiatry. 2022 Jul 1;13:933025. doi: 10.3389/fpsyt.2022.933025. eCollection 2022.
Schizophrenia is a severe mental disorder that is often comorbid with heart dysfunction and even sudden cardiac death (SCD). Clinical studies of SCD in schizophrenia have been largely reported, while there are limited autopsy studies that directly showed whole-scale information of such events. In this study, we present nine autopsy-based SCD cases in schizophrenia patients who died suddenly during hospitalization. Their medical records before and during hospitalization, and postmortem autopsy findings were summarized. These decedents had an average duration of schizophrenia for 6.83 ± 3.75 years with a male/female ratio of 4:5. They were all on intermittent antipsychotics medication before hospitalization and died within 15 days after hospitalization. Seven of the nine cases (77.8%) died of organic heart diseases such as severe coronary artery atherosclerosis ( = 4), myocarditis ( = 1), cardiomyopathy ( = 1), and pulmonary thromboembolism ( = 1). Two cases remained unexplained after systemic autopsy and toxicological examinations. Postmortem autopsy identified hepatic steatosis ( = 6) and respiratory inflammation ( = 3) as the most common associate extra-cardiac lesions. Our data provided autopsy-based data of SCD cases in schizophrenia and highlighted an intensive care of such patients during hospitalization.
精神分裂症是一种严重的精神障碍，常与心脏功能障碍甚至心源性猝死（SCD）合并存在。关于精神分裂症患者心源性猝死的临床研究已有大量报道，但直接展示此类事件全面信息的尸检研究却很有限。在本研究中，我们呈现了9例在住院期间突然死亡的精神分裂症患者基于尸检的心源性猝死病例。总结了他们住院前及住院期间的病历以及尸检结果。这些死者精神分裂症的平均病程为6.83±3.75年，男女比例为4:5。他们在住院前均接受间歇性抗精神病药物治疗，并在住院后15天内死亡。9例中有7例（77.8%）死于器质性心脏病，如严重冠状动脉粥样硬化（4例）、心肌炎（1例）、心肌病（1例）和肺血栓栓塞（1例）。经过系统尸检和毒理学检查后，仍有2例死因不明。尸检发现肝脂肪变性（6例）和呼吸道炎症（3例）是最常见的心脏外相关病变。我们的数据提供了精神分裂症患者心源性猝死病例基于尸检的数据，并强调了对此类患者住院期间的重症监护。
