Yuzuriha T, Nakamura T, Shoji M, Matsushita S, Takagi S, Kono H
Tokyo Metropolitan Medical Examiner's Office, Japan.
Arukoru Kenkyuto Yakubutsu Ison. 1993 Jun;28(3):95-119.
Seven thousand three hundred seventy-six sudden or violent manner of deaths were inspected or autopsied at Tokyo Metropolitan Medical Examiner's Office in 1989. Out of these victims, 693 (9.4%) victims were regarded as heavy drinkers on the basis of the drinking habits and the autopsy reports and 196 (2.7%) victims without past problem drinking were thought to be drunk at death from the family statements or the blood alcohol analysis. The total 889 (12.1%) alcohol-related cases (autopsy was performed on the 489 cases) were studied from epidemiological and etiological viewpoints. The average age of the alcohol-related victims (male: 811, female: 78) was 52 +/- 11 years. In middle-aged (45-54 years) men, 34% of the all sudden or violent deaths were alcohol-related. About half of the alcohol-related victims were living alone and jobless and they often died at home, particularly in the bed. In the alcohol-related victims, the blood alcohol concentration (BAC) analysis revealed that the average BAC of female was significantly higher than that of male. (2.12 +/- 1.73 mg/ml vs. 1.33 +/- 1.75, P < 0.01). This difference may be associated with sex difference in ethanol metabolism, body composition and drinking habits. Among the major causes of the alcohol-related deaths, alcoholic liver diseases accounted for 226 (25%), gastro-intestinal bleedings for 115 (13%), cardiovascular diseases for 105 (12%) and violent deaths (e.g., acute alcohol intoxication, falls, traffic accidents, suicide) for 329 (37%). By histopathological examination of the liver, about 30% of the alcoholic liver disease cases showed mainly fatty metamorphosis and 48% showed liver cirrhosis. Only 12% of the cirrhotics had either jaundice or ascites, suggesting hepatic failure. Alcoholic cardiomyopathy was suspected in only 11 cases. In conclusion, many people, particularly middle-aged men, lose their lives due to heavy drinking and there are many pathologically unexplainable sudden deaths of alcoholics.
1989年，东京都立法医事务所对7376例猝死或暴力死亡案例进行了检查或尸检。在这些受害者中，根据饮酒习惯和尸检报告，693名（9.4%）受害者被视为酗酒者，196名（2.7%）既往无饮酒问题的受害者根据家属陈述或血液酒精分析被认为在死亡时处于醉酒状态。从流行病学和病因学角度对总共889例（12.1%）与酒精相关的案例（其中489例进行了尸检）进行了研究。与酒精相关的受害者的平均年龄（男性：811例，女性：78例）为52±11岁。在中年（45 - 54岁）男性中，所有猝死或暴力死亡案例中有34%与酒精有关。约一半与酒精相关的受害者独居且无业，他们常死于家中，尤其是死在床上。在与酒精相关的受害者中，血液酒精浓度（BAC）分析显示女性的平均BAC显著高于男性。（2.12±1.73mg/ml对1.33±1.75，P < 0.01）。这种差异可能与乙醇代谢、身体组成和饮酒习惯方面的性别差异有关。在与酒精相关的死亡主要原因中，酒精性肝病占226例（25%），胃肠道出血占115例（13%），心血管疾病占105例（12%），暴力死亡（如急性酒精中毒、跌倒、交通事故、自杀）占329例（37%）。通过肝脏组织病理学检查，约30%的酒精性肝病病例主要表现为脂肪变性，48%表现为肝硬化。只有12%的肝硬化患者有黄疸或腹水，提示肝功能衰竭。仅11例疑似酒精性心肌病。总之，许多人，尤其是中年男性，因酗酒而丧生，并且酗酒者存在许多病理上无法解释的猝死情况。
