2009年云南不明原因猝死流行病学和临床特点分析

Analysis on the epidemiological and clinical features of Yunnan sudden unexplained death in 2009

目的 描述2009年云南不明原因猝死（YSUD）的流行病学和临床特点.方法 采用统一调查表,调查猝死病例的家庭成员、见证人和诊治医生,查阅诊治记录,收集猝死病例流行病学和临床信息.结果 2009年云南省5个县的5个自然村报告7起YSUD事件,共22人受罹,其中猝死16例（72.73%）,同发病例6例（27.27%）.16例猝死病例分布于7个家庭,家庭聚集性猝死病例14例,占87.50%（14/16）.15例（93.75%）发生于既往无YSUD事件报告的村庄.猝死病例分布于7月5例（31.25%）,8月11例（68.75%）;男性8例,女性8例;中位年龄31岁（10～67岁）,其中20～39岁年龄组10例,占62.50%.猝死者死亡中位时间为5 min（3～115 min）.5例猝死者死前无任何临床表现,其中倒地而亡3例和睡眠时死亡2例;10例死亡前表现为口唇发绀、胸痛、头晕、心悸、面色苍白、头痛、抽搐、晕厥等,均无发热症状.结论 2009年YSUD事件中,除1例外均发生在过去无猝死报告的村庄,发生季节、聚集性及临床特点与以往YSUD事件情况基本一致.

Objective To describe the epidemiological and clinical features of Yunnan sudden unexplained death （YSUD） incident in 2009. Methods Using the standard questionnaire, the family members of the cases, witnesses and doctors were interviewed, the medical files and clinical information of YSUD cases were collected. Results 16 sudden unexplained death （YSUD） cases （72.73%） and 6 ill cases （27.27%） were reported in 7 YSUD incidents in 5 villages of 5 counties in Yunnan province. 15 cases （94%） were reported at villages where no YSUD cases reported before. 16 SUDcases occurred in 7 families and 87.5%（14/16） of cases were family clustering cases. 5（31.25%） and 11 （68.75%） of the SUD occurred in July and August respectively. 8 were male and 8 were female. The median of cases＇age was 31 （10-67）, and 10 cases（62.50%） were 20-39 years old. The median duration from acute onset to death was 5 minutes（3-115 min）. No complaints or signs of 5 cases was observed before death, 3 of them were falling to death and the other two died during sleeping. The acute onset symptom of 10 cases were observed mainly a s cyanosis, chest pain,dizzy, pain facial expression, palpitations, pale face, headache, spasm, syncope, and urinary incontinence（20%）.Conclmions All the YSUD affected villages but one in 2009 are reported for the first time. The high-occurrence season,clustering of distribution and clinical features of YSUD in 2009 are observed mainly in accordance with the YSUD in the past.