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80例心性猝死病因以冠心病居首位(56例,70.0％),其临床与病理所见可归纳为:(1)年龄较轻;多无心血管病既往史。(2)既往心电图多示心律失常及(或)ST-T改变。(3)尸检心脏多肥大;冠脉病变较轻也不广泛;可累及心脏传导系统。(4)3例睡眠猝死的心血管未见明显病变,可能由于冠脉痉挛所致。(5)本组猝死者临床与病理变化多不严重,其发病机制难以单纯心血管病变来阐明。可能由于一时附加某种诱因损伤心脏或加重心肌缺血,迅速触发致死性心律失常。故应监测和控制猝死前的各种重度心律失常。一旦发生猝死,应在就地采取迅速有效的复苏措施的同时,并尽快作心电图检查,俾能有针对性地采用控制心律失常药剂或其它除颤、起搏等措施。
The cause of sudden cardiac death in 80 cases was coronary heart disease (56 cases, 70.0%). The clinical and pathological findings can be summarized as follows: (1) younger age, and no history of cardiovascular disease. (2) previous ECG multiple manifestations of arrhythmia and (or) ST-T changes. (3) autopsy heart hypertrophy; lesser coronary lesion is not widespread; can affect the cardiac conduction system. (4) There were no obvious pathological changes in 3 cases of sudden death of the cardiovascular system, which may be caused by coronary spasm. (5) The sudden death in this group of patients with more serious clinical and pathological changes, its pathogenesis is difficult to clarify simple cardiovascular disease. May be due to a temporary additional incentive to damage the heart or aggravate myocardial ischemia, rapid trigger fatal arrhythmias. It should be monitoring and control of sudden death before a variety of severe arrhythmia. In the case of sudden death, quick and effective recovery measures should be taken on the spot and an electrocardiogram examination should be carried out as soon as possible so as to control the arrhythmia agent or other defibrillation and pacing measures in a targeted manner.