慢型克山病死亡病例中猝死病例分析

Analysis in the sudden death cases with chronic Keshan disease

目的 了解慢型克山病猝死的有关因素 ,在防治工作中采取有针对性的措施 ,以减少或避免猝死的发生。方法 设计慢型克山病死亡 (病死、猝死、意外死亡 )病例有关资料的统一调查表 ,由专业人员查阅有关病例资料填写。工作结束后进行表格汇总、统计与分析。结果 慢型克山病无论病程长短都可能发生猝死 ,女性明显多于男性 ,发病在 5年内猝死的最多 ,猝死的发生主要由左心室大劳损合并多源多发、单源多发性室性早搏及各种传导阻滞 ,再在诱发因素的作用下所引起。结论 在慢型克山病病人中 ,一般情况下是心胸比率越大、心功能越差 ,猝死的机会越大 ,但心功能在 级、心胸比率在 0 .5 1～ 0 .5 5之间的病例猝死率也较高。

Objective To study the cause of sudden death occurred in patients with chronic Keshan disease and reduce the sudden death rate.Methods The investigation form including the data of sudden death cases was employed and filled in by subjects in a specific field, then the data was gathered counted and analyzed.Results All the patients with chronic Keshan disease could encounter sudden death independent of the stages of the disease, the sudden death rates in females were much more frequent than those in males,the proportion of sudden death occurred within 5 years was the highest. The main factors of sudden death included left ventricular enlargement, mixed frequent multi focal and simple ventricular premature contractions, and all kinds of heart conduction blocks.Conclusions Ventricular hypertrophy with impaired function predicted a higher occurrence of sudden death, however, it was not unusual to find the patients whose heart functions were level Ⅱand heart and chest ratios were between 0.51～0.55.