目的 研究广东地区622例猝死案例的流行病学特征,为探讨猝死的发病机制、鉴定指标提供基础依据.方法 收集中山大学法医鉴定中心2009至2012年622例确诊猝死的案例,运用统计学方法对一般情况、临床病历、法医学尸体解剖所见及病理学诊断等资料进行回顾性分析.结果 622例中心源性猝死为主要类型,占59.49%,以中青年男性多见(30~50岁男性占43.78%),冠心病为主要病因,发病呈年轻化(≤35岁者占17.89%);心源性猝死、其它系统疾病猝死、不明原因猝死3组之间心脏重量存在明显差异(P<0.05);青壮年猝死综合征与心源性猝死组中胸腺肥大或出血阳性率存在差异(P<0.05).结论 心源性猝死为猝死主要类型,发病呈年轻化,中青年男性为甚,冠心病为主要病因;胸腺肥大或出血引起个体应激系统障碍可能是致猝死机制之一.
Objective To analyze the epidemiological features of 622 cases with sudden death (SD) and provide the valuable guidance for the diagnosis of SD. Methods 622 cases of SD during 2009 ~ 2012 in Center for Medicolegal Expertise of Sun Yat-sen University were collected. The general information of the cases, clinical characteristics, the medicolegal autopsy and histopathological diagnosis were retrospectively analyzed. Results Among the 622 cases of SD, 370 cases died of sudden cardiac death (SCD). The main cause of SCD was coronary heart disease. The heart weight in SCD , SUD and sudden death caused by other system diseases were different ( P 〈 0. 05 ). The incidence rates of thymus hypertrophy and hemorrhage ~owed statistically different between SCD and SMDS (P 〈 0. 05). Conclusion In sudden death, the most common death was SCD (59. 49% ), 30 -50 years old males accounted for 43.78 %. The main cause of sudden cardiac death were coronary heart disease, more and more younger tend to suffer SCD. Part of sudden unexplained death may be SCD. Thymus hypertrophy or bleeding causing individual stress system disorder maybe one causes of sudden death.