哮喘猝死患者的心肺病理分析

Cardio-pulmonary pathology of sudden death in asthma

目的 提高对哮喘猝死的认识 ,了解其心、肺病理学特征和死亡原因。方法 对 14例哮喘猝死患者的病理资料进行分析。结果 哮喘猝死患者无性别差异 ,年龄 30岁以下者 9例(6 4 3% ) ;病理改变的特点为支气管管壁嗜酸细胞浸润 14例 (10 0 % ) ,粘膜基底膜增厚 12例(85 7% ) ,支气管平滑肌细胞增生 11例 (78 6 % ) ,粘液腺增生、肥大 9例 (6 4 3% ) ,细支气管内粘液栓形成 8例 (5 7 1% ) ;左心室壁瘢痕形成 10例 (71 4% ) ,病变主要位于左心室侧壁和心尖部。结论 哮喘猝死患者气道存在明显的非特异性炎症反应 ,心肌受损和细支气管粘液栓形成为其主要致死原因。

Objective To elucidate the pathological characteristics of the heart and lung in asthmatics with sudden death. Method A detail analysis of pathological data was performed on 14 patients with sudden death in asthma. Results There was no apparent gender difference among 14 patients 9 patients were younger than 30 years old Pathological examination showed that bronchial infiltration of eosinophils in 14 patient (100%), thickened basement membrane of the bronchial mucosa in 12 patients (85 7%), proliferation of smooth muscle cells in 11 patients (78 6%), proliferative mucous gland in 9 patients (64 3%), mucous plug in bronchiole in 8 patients (57 1%), and cicatvization of left ventricle in 10 patients (71 4%). Conclusion Severe nonspecific airway inflammation is demonstrated in asthmatic patients with sudden death. Lesions of the left ventricle and mucous plug in bronchiole may contribute to the main cause leading sudden death