冠心病猝死的病理学研究——附128例尸检分析

本文报道128例冠心病猝死的法医病理学研究结果。其中冠脉病变4级63例,3级26例,2级29例。3级以上病变者斑块分布多较广泛。各支病变中以左前降支最常见。并发新鲜血栓形成者18例,斑块内出血17例,急性心肌梗死仅2例。36例冠脉斑块有炎性细胞浸润。56例见心肌间质纤维化或小灶疤痕形成。指出虽然我国冠心病发病率较低,但仍是猝死最常见的原因,尤以中壮年男性多见;多数病例无明显诱因而于睡眠中猝死。对冠心病猝死发生的特点、冠脉和心肌病变及病理诊断等进行了分析讨论。

PATHOLOGICAL STUDY OF SUDDEN CORONARY DEATH——REPORT OF 128 AUTOPSY CASES

This paper reports the results of forensic pathological study of 128 autopsycases of sudden coronary death(SCD).The severity of the coronary arterystenosis was 4 degree in 63 cases,3 degree in 26 cases and 2 degree in 39 cases.The distribution of the artheroscleorosis of 3 and 4 degree was quite extensive. Recent thrombosis in CA was found in 18 cases,hemorrhage in plaques in 17cases.Only 2 cases had acute myocardial infarction.Inflammatory cell infil-tration were found in coronary plaques in 36 cases.Myocardail fibrosis orsmall scar formation were detected in 56 cases.It is suggested that SCD isthe commonest cause of sudden unexpected death.The majority of SCD(61%)were manhood in middle age.Most cases died suddenly during sleep withoutany clear inducements.The characteristics of the pathological changes in theCA and myoc ardium and the pathological diagnosis of SCD were analyzedand discussed.