心源性猝死诸因素及防治研究

Study on factors and prevention and treatment of sudden cardiac death

目的：总结与心源性猝死有关的危险因素，为临床上防治心源性猝死疾病提供参考。方法回顾性分析1995年12月～2014年12月期间我部收治抢救的62例心源性猝死患者的临床资料，分析62例心源性猝死患者的临床特点及相关因素。结果（1）急救结果：成功复苏患者为11例，占17.74%，死亡51例，占82.26%。（2）心源性猝死的发生与冠心病相关性很强，占76.48%，猝死前多有严重的心律失常和心功能不全。（3）心源性猝死的常见诱发原因为心理应激状态（35.29%），用力排便（21.57%），运动或过度劳累（19.61%）等。（4）在心源性猝死诸多危险因素中，包括高血压病、糖尿病、高血脂、动脉粥样硬化、吸烟、饮酒等。（5）心源性猝死患者在发病年龄段、性别、发作时间、发作季节、心电图特征、基础疾病等方面差异具有统计学意义（P ＜0.05）。结论临床上防治心源性猝死的关键，在于提高对心源性猝死的诱发因素和危险因素的重视程度。

Objective To summarize risk factors related to sudden cardiac death and provide reference for the prevention and treatment of sudden cardiac death disease. Methods Clinical data of 62 patients with sudden cardiac death who were admitted to our department from December 1995 to December 2014 were collected. Clinical characteristics and related factors of sudden cardiac death of 62 patients were analyzed retrospectively. Results （1） Results of emergency treatment： 11 resuscitated patients accounted for 17.74 while 51 dead patients accounted for 82.26%. （2） The correlation of sudden cardiac death and coronary heart disease was very strong accounting for 76.48% and most patients had severe arrhythmia and heart failure before sudden death. （3） Common induced factors to sudden cardiac death included psychological stress state （35.29%）, straining defecation （21.57%） and exercise or excessive tire （19.61%） etc. （4） Risk factors to sudden cardiac death included hypertension, diabetes, hyperlipidemia, atherosclerosis, smoking and drinking, etc. （5） The suffering age stage, gender, duration of seizure, seizure season, ECG characteristics and underlying diseases, etc. of patients with sudden cardiac death were statistically significant （P 〈 0.05）. Conclusion The key of prevention and treatment for sudden cardiac death in clinical treatment is paying more attention to induced factors and risk factors of sudden cardiac death.