冠心病合并冠状动脉血栓猝死的法医病理学特征

目的探讨冠心病合并冠状动脉血栓形成导致猝死的法医学特征。方法收集96例因冠心病而猝死的案例,并将其分为血栓形成组与无血栓形成组,对发病时间、诱因、病理特征等方面进行分析。结果两组都以男性为主,在季节和时间节律分布、诱因构成上差异无统计学意义,但血栓形成组中年龄〈40岁发病率更高;血栓形成组的心脏质量和冠脉狭窄程度低于无血栓形成组,而两组冠脉粥样硬化累及的支数（≥2）、累及长度及合并心梗等指标差异均无统计学意义,但血栓形成组有低于无血栓形成组的趋势。结论两组人群都以男性为主且发病诱因、冠脉病变部位及致死机制相似,但血栓形成组的发病年龄较轻,心脏的病变程度较低,法医学解剖中当认真鉴别。

Pathological characteristics of sudden death caused by coronary thrombosis

Objective To explore medico-legal characteristics of sudden death caused by coronary heart disease combined with coronary thrombosis.Methods Ninety-six cases of sudden death caused by coronary heart disease were collected and divided into two groups： thrombus positive and thrombus negative groups.The time onset,induction and pathological features of coronary artery disease were analyzed.Results Two groups showed man-dominant population.There were no statistical significant differences in season,circadian rhythm and induction factor.The thrombus positive group（age40） showed a higher disease incidence.Heart weight and degree of coronary stenosis were lower in thrombus positive group.However,there was no statistical difference in the number of atherosclerotic coronary arteries（≥2）,the length of coronary lesions and myocardial infarct.But thrombosis positive group showed lower tendency.Conclusion Two groups are man-dominant population and similar induction factor,lesion position,mechanism of death.But thrombus positive group appeared more in a younger population and the degree of coronary stenosis is milder than thrombus negative group.Forensic pathologists should pay more attention to these characteristics in death investigation.