Shen W K, Edwards W D, Hammill S C, Bailey K R, Ballard D J, Gersh B J
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Am J Cardiol. 1995 Jul 15;76(3):148-52. doi: 10.1016/s0002-9149(99)80047-2.
The objective of this study was to evaluate the incidence and correlates of sudden unexpected nontraumatic death among young adults in a well-surveyed population. The incidence and pathogenesis of sudden unexpected nontraumatic death in a young adult population (aged 20 to 40 years old) have not been well defined. All residents 20 to 40 years old from Olmsted County, Minnesota, who had nontraumatic sudden death between 1960 and 1989 were included. Histologic and gross cardiac specimens were examined. The incidence of sudden death was estimated based on the ratio of number of observed events to relative census data for the Olmsted County population from the last 3 decades. Statistical comparisons between age decades were obtained with the chi-square test. Incidence trends were tested using Poisson regression. Of the 54 subjects, 19 were women (4.1/10(5) population annually) and 35 were men (8.7/10(5) population annually). An increase in incidence of sudden death was evident in men. Causes of death included coronary artery disease, noncardiovascular disease, suspected primary arrhythmia, vascular disease, myocarditis, hypertrophic cardiomyopathy, and unknown causes. Gross and histologic features suggestive of right ventricular dysplasia were found in 9 subjects (17%), but 6 of these 9 had other established causes of death. Of the 27 sudden deaths between 1980 and 1989, 9 (33%) had a history of cocaine abuse. A trend in increasing incidence of sudden death in young men is noted. A high prevalence of cocaine abuse was observed in young adults who died suddenly. Histologic features of right ventricular dysplasia were prevalent but were not necessarily the primary cause of death.
本研究的目的是评估在一个经过充分调查的人群中，年轻成年人意外非创伤性猝死的发生率及其相关因素。年轻成年人群体（20至40岁）意外非创伤性猝死的发生率和发病机制尚未明确界定。纳入了明尼苏达州奥尔姆斯特德县1960年至1989年间发生非创伤性猝死的所有20至40岁居民。对心脏组织学和大体标本进行了检查。根据观察到的事件数量与奥尔姆斯特德县过去三十年人口相对普查数据的比例，估算猝死发生率。采用卡方检验对不同年龄十年间进行统计比较。使用泊松回归检验发生率趋势。54名受试者中，19名是女性（每年每10(5)人口中有4.1人），35名是男性（每年每10(5)人口中有8.7人）。男性猝死发生率明显上升。死因包括冠状动脉疾病、非心血管疾病、疑似原发性心律失常、血管疾病、心肌炎、肥厚型心肌病以及不明原因。9名受试者（17%）发现有提示右心室发育异常的大体和组织学特征，但这9名中的6名有其他已明确的死因。在1980年至1989年间的27例猝死中，9例（33%）有可卡因滥用史。注意到年轻男性猝死发生率呈上升趋势。在突然死亡的年轻成年人中观察到可卡因滥用的高流行率。右心室发育异常的组织学特征普遍存在，但不一定是主要死因。
