Yamaguchi J, Shikano Y, Sato S, Shimamoto K
Department of Pathology, Obihiro Kosei Hospital, Japan.
Nihon Ronen Igakkai Zasshi. 1995 Nov;32(11):722-7. doi: 10.3143/geriatrics.32.722.
A series of 46 autopsied adult cases of sudden and unexpected natural death were investigated. In this study, sudden and unexpected death was defined as any death occurring with 24 hours of onset of symptoms in a person with or without probable cause of death suggested by medical history. The cases included 31 males and 15 females aged 26 to 85 years (mean 66.6 years). Age distribution peaked in seventies. The lesions causing sudden and unexpected death according to the most frequent organ systems were, diseases of the heart (acute myocardial infarction with or without old infarct, 20; old myocardial infarction without acute infarction, 2; dilated cardiomyopathy, 2; sarcoidosis, 1; amyloidosis, 2; and valvular disease, 2), the aorta (ruptured aneurysm, 6; dissecting aneurysm, 2), the respiratory tract (pulmonary embolism, 7; pulmonary hypertension, 1), the alimentary tract (intestinal obstruction, 1), and other diseases (cause unknown, 1). The cardiovascular lesions were found in 78.2% of cases autopsied. The sudden and unexpected death caused by acute myocardial infarction was found in 47.8%, and acute myocardial infarction seemed to play a major role in cardiac sudden death in these series. The respiratory lesions were found in 17.4%. Four of seven cases with pulmonary embolism died in two weeks after surgical operation. The most common underlying disease was post-operative condition.
对46例成人自然性猝死且死因不明的尸体解剖病例进行了调查。在本研究中，猝死且死因不明被定义为：无论病史是否提示可能的死因，任何在症状出现24小时内发生的死亡。这些病例包括31名男性和15名女性，年龄在26至85岁之间（平均66.6岁）。年龄分布在七十岁达到峰值。根据最常涉及的器官系统，导致猝死且死因不明的病变有：心脏疾病（伴有或不伴有陈旧性梗死的急性心肌梗死，20例；无急性梗死的陈旧性心肌梗死，2例；扩张型心肌病，2例；结节病，1例；淀粉样变性，2例；瓣膜病，2例），主动脉（动脉瘤破裂，6例；夹层动脉瘤，2例），呼吸道（肺栓塞，7例；肺动脉高压，1例），消化道（肠梗阻，1例），以及其他疾病（病因不明，1例）。在接受尸检的病例中，78.2%发现有心血管病变。急性心肌梗死导致的猝死且死因不明占47.8%，在这些病例系列中，急性心肌梗死似乎在心脏性猝死中起主要作用。呼吸道病变占17.4%。7例肺栓塞病例中有4例在手术后两周内死亡。最常见的基础疾病是术后状况。
