冠心病猝死的相关因素分析

Analysis of relative factor of sudden death of coronary heart disease

目的探讨冠心病患者心脏性猝死的发生率及其相关因素。方法回顾分析46例冠心病患者住院期间发生心脏性猝死的有关临床资料，男性32例，女性14例，年龄38-83（49．5±10．7）岁。收集患者的诱因、心电图（ECG）、超声心动图、动态心电图、X线胸片、心电监护、电解质等资料，根据患者相关项目逐项进行分析。结果46例猝死患者占同期冠心病总住院数的2．2％。多数发生猝死的冠心病患者存在一定高危因素，电解质紊乱、Lown3-5级室早、高度房室传导阻滞、束支传导阻滞、心脏扩大、左室肥厚、心功能不全、持续心肌缺血等因素均可触发致命性心律失常；猝死起始的ECG类型及其演变过程多有一定规律性。结论冠心病患者的心脏性猝死发生率为2．2％。冠心病患者发生猝死与电解质紊乱、Lown3-5级室早、高度房室传导阻滞、束支传导阻滞、心脏扩大、左室肥厚、心功能不全、持续心肌缺血等高危因素密切相关。有效控制危险因素能大大降低冠心病猝死发生率。

Objective To explore the relative factors of sudden death of coronary heart disease for improving the resuscitation rate. Methods The usual etiology of sudden death of coronary heart disease, electrocardiogram （ECG）, echocardiography, dynamic electrocardiography （DCG）, X-ray and electrolystes were analysed. Results Most sudden death have inducement. Electrolytes disorder, ventficular ectopic beats of Lown 3-5, high grade atrioventricular block, branch block, auxocardia, left ventricular hypertrophy, cardiac insufficiency and myocardial ischemia may cause serious arrhythmias. The earlier change of ECG of sudden death may have some regularity. Conclusion The incidence of Suddendeath in patients with Coronary diseasewas 2.2%. It may be related toElectrolytes disorder, ventricular ectopic beats of Lown 3-5, high grade atrioventricular block, branch block, auxocardia, left ventricular hypertrophy, cardiac insufficiency and myocardial ischemia in patients with SCD. The use of Clinical efforts may reduce the rate of sudden death of coronary heart disease significantly.