2004年云南省腾冲县云南不明原因猝死疫情的调查分析

Investigation and Analysis on Yunnan Unexpected Sudden Death in Tengchong County of Yunnan Province in 2004

目的探讨云南不明原因猝死的流行特点、临床表现和病因,为制定有效的防治措施提供依据。方法通过现场调查,收集和分析流行病学资料和临床资料,通过尸体解剖进行病理学检查和临床学研究。结果本起疫情发生在7月上旬,2天内发病4人,死亡4人,发病者均为农民,未发现同发病例。4个病例的临床表现不完全一致,2个10天前有上呼吸道感染症状,1个有约3天的病程,表现为乏力、头昏、胸闷、气促等,1个无任何表现;3个死亡病例表现为心源性猝死。病毒检测结果:1位健康家属的粪便中分离到1株新型肠道病毒;2例死亡病例的尸体病理检查结果表现不同。结论本病有明显的地区性、季节性、家庭和或村庄聚集性;发病率低,病死率高;临床表现不特异,以心源性猝死为主,诊断和救治很困难。

Objective To explore the epidemiological and clinical features and etiopathogenisis of unexpected sudden cardiac deaths （ USCD ） in Yunnan to provide basis for formulating effective control measures of USCD. Methods The epidemiological and clinical data were collected in the field. The pathology and clinical manifestation of USCD were studied. Results The USCD event occurred in Tengchong County of Yunnan Province in July 2004. There were 4 death cases, who were farmers. The clinical manifestation of the 4 death cases were different. Out of them, there were 2 cases with flu symptom 10 days before, 1 case showing tired, giddy, short of breath and so on, and 1 case without any symptoms before death. A new strain of enteric virus was isolated from the faececs of a healthy grandchild of 1 case. The pathological examination on cadavers of 2 cases was different. Conclusions The extreme time - space clustering of USCD in families and in villages is observed. Its incidence rate is low, but the fatality rate is high. The clinical manifestation of USCD is very complicated. The most death is the sudden cardiac death. It is difficult to diagnose and rescue.