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目的 研究癫患者不明原因突然死亡 (SUDE)的临床和病理特征。方法 对 7例符合美国食品药品管理局SUDE标准的癫患者的临床资料和病理特征进行分析。结果 病理切片显示全部患者都存在脑水肿和肺水肿 ,部分患者有神经细胞数量减少和胶质细胞增多 ,无占位性改变 ,也没有发现明显的脑部损伤。其中 2例在睡眠中死亡 ,4例死亡前有情绪激动或惊恐史 ,7例患者均在出现全身强直 阵挛性发作时死亡。结论 脑水肿、肺水肿、多种胶质细胞增生及神经元数量减少是SUDE的主要病理改变 ,但无特异性。情绪激动、发作未能有效控制和全身强直 阵挛性发作是SUDE患者重要诱因 ,SUDE易发生在睡眠中。
Objective To study the clinical and pathological features of unexplained sudden death (SUDE) in epileptic patients. Methods Clinical data and pathological features of seven patients with epilepsy who met the SUDE criteria of the FDA were analyzed. Results Pathological examination showed that all patients had cerebral edema and pulmonary edema. In some patients, the number of nerve cells and glial cells increased, there was no space-occupying changes and no obvious brain injury was found. Two of them died during sleep, and four had a history of emotional or panic before death, all of whom died in a generalized tonic-clonic seizure. Conclusions Cerebral edema, pulmonary edema, multiple glial cell proliferation and the number of neurons are the main pathological changes of SUDE, but they are not specific. Emotional, seizures failed to effectively control and generalized tonic clonic seizures is an important incentive for patients with SUDE, SUDE prone to sleep.