目的探讨冠心病合并冠状动脉血栓形成导致猝死的法医学特征。方法收集96例因冠心病而猝死的案例,并将其分为血栓形成组与无血栓形成组,对发病时间、诱因、病理特征等方面进行分析。结果两组都以男性为主,在季节和时间节律分布、诱因构成上差异无统计学意义,但血栓形成组中年龄〈40岁发病率更高;血栓形成组的心脏质量和冠脉狭窄程度低于无血栓形成组,而两组冠脉粥样硬化累及的支数(≥2)、累及长度及合并心梗等指标差异均无统计学意义,但血栓形成组有低于无血栓形成组的趋势。结论两组人群都以男性为主且发病诱因、冠脉病变部位及致死机制相似,但血栓形成组的发病年龄较轻,心脏的病变程度较低,法医学解剖中当认真鉴别。
Objective To explore medico-legal characteristics of sudden death caused by coronary heart disease combined with coronary thrombosis.Methods Ninety-six cases of sudden death caused by coronary heart disease were collected and divided into two groups: thrombus positive and thrombus negative groups.The time onset,induction and pathological features of coronary artery disease were analyzed.Results Two groups showed man-dominant population.There were no statistical significant differences in season,circadian rhythm and induction factor.The thrombus positive group(age40) showed a higher disease incidence.Heart weight and degree of coronary stenosis were lower in thrombus positive group.However,there was no statistical difference in the number of atherosclerotic coronary arteries(≥2),the length of coronary lesions and myocardial infarct.But thrombosis positive group showed lower tendency.Conclusion Two groups are man-dominant population and similar induction factor,lesion position,mechanism of death.But thrombus positive group appeared more in a younger population and the degree of coronary stenosis is milder than thrombus negative group.Forensic pathologists should pay more attention to these characteristics in death investigation.