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[意外性心脏猝死。1000例尸检分析]

[Unexpected sudden cardiac death. An evaluation of 1000 autopsies].

作者信息

Loire R, Tabib A

机构信息

Hôpital cardiovasculaire et pneumologie Louis-Pradel, Lyon.

出版信息

Arch Mal Coeur Vaiss. 1996 Jan;89(1):13-18.

PMID:8678733
Abstract

The aim of this study was to search for a cardiac cause of death after an otherwise negative medico-legal autopsy in 1,000 adults under 65 years of age with no previous history, who suffered a sudden death. Four hundred and seven coronary causes were established with 152 negative autopsies and 441 other cardiac lesions. These 441 cases comprised 193 cardiomyopathies, 106 His bundle lesions, 50 partial forms of Uhl's anomaly (or arrhythmogenic right ventricular dysplasia), 14 isolated mitral valve prolapses, 22 chronic valvular lesions, 8 myocarditis, 16 pulmonary embolisms, 11 chronic cor pulmonale, 11 aortic dissections and 10 atrophic fibrous plaques of the left ventricle, sequellae of thoracic trauma. His bundle lesions (isolated and associated) were observed 299 times out of 1,000 cases and mitral valve prolapse 125 times. Age and gender, circumstances of sudden death, the weight of the heart, are reported for each group of conditions. The frequency of associations, especially of His bundle lesions, suggests that they may have a potentialising effect on the genesis of the fatal arrhythmia.

摘要

本研究的目的是在1000名65岁以下无既往病史且猝死的成年人中,寻找死因,这些人的法医尸检结果为阴性。确定了407例冠状动脉病因,其中152例尸检结果为阴性,441例为其他心脏病变。这441例病例包括193例心肌病、106例希氏束病变、50例部分形式的乌尔畸形(或致心律失常性右心室发育不良)、14例孤立性二尖瓣脱垂、22例慢性瓣膜病变、8例心肌炎、16例肺栓塞、11例慢性肺源性心脏病、11例主动脉夹层和10例左心室萎缩性纤维斑块(胸部创伤后遗症)。在1000例病例中,观察到希氏束病变(孤立性和相关性)299次,二尖瓣脱垂125次。报告了每组疾病的年龄、性别、猝死情况、心脏重量。关联的频率,尤其是希氏束病变的频率,表明它们可能对致命性心律失常的发生具有潜在的促进作用。

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