178例心源性猝死法医组织病理学诊断分析

Forensic Histopathological Diagnostic Analysis of Sudden Cardiac Death in 178 Cases

目的探讨心源性猝死(SCD)的病理特点与鉴别要点。方法对四川华西法医学鉴定中心2000—2005年尸检出的178例SCD死亡案例进行回顾性分析,主要对其病因、年龄、诱因及病理改变进行分析。结果本组资料显示冠心病、心传导系统病变、心肌炎、心肌病等在SCD中占有较大比例。冠心病猝死是中老年人SCD的最主要原因,青壮年人SCD的病因以非冠心病为主。如传导系统病变、心肌炎、心肌病。在儿童的SCD中先天性心脏病、传导系统病变及心肌炎占主导地位。结论不同的病因,其病理特点不同,其病理变化是法医学鉴定的主要依据。

Objective To investigate the pathological characteristics and differential diagnosis of sudden cardiac death （SCD）. Methods The causes and ages of death, the predisposing factors, and the pathological changes of SCD were analyzed according to the anatomical and pathological materials of SCD in 178 cases in our college. Results The data showed that coronary artery disease, conduction system abnormality, myocarditis, and cardiomyopathy are main causes of SCD. Coronary artery disease was the main cause of SCD in elderly; while conduction system abnormality, myocarditis, and cardiomyopathy were main causes of SCD among young adults. The congenital heart disease, conduction system defects, and myocarditis were more common in children. Conclusion Etiology determines pathological characteristics. The pathological changes are what forensic medicine rely on to make a diagnosis.