云南七个家庭不明原因猝死的临床研究
운남칠개가정불명원인졸사적림상연구
Clinical features of unexpected sudden death clustered in 7 families in Yunnan Province
  • 万方数据
    中华心血管病杂志 중화심혈관병잡지
    Chinese Journal of Cardiology
    2008年 7期 613-617 ,共5页

    张健%施国庆%HUANG Wen-li%鲍建中%YE Shao-dong%任金马%LI Zhao-xiang%俞梦越%GAO Xin%王跃兵%罗彤%LI Chong-jian%杨林%任晓庆%赵塑%宋来凤%NIU Cun-long%王红月%ZHAO Hong%Robert.E Fountaine%YANG Chong-fu%浦介麟%YANG Yue-jin%曾光

    장건%시국경%HUANG Wen-li%포건중%YE Shao-dong%임금마%LI Zhao-xiang%유몽월%GAO Xin%왕약병%라동%LI Chong-jian%양림%임효경%조소%송래봉%NIU Cun-long%왕홍월%ZHAO Hong%Robert.E Fountaine%YANG Chong-fu%포개린%YANG Yue-jin%증광

    猝死%症状和体征%偏性(流行病学)%云南 猝死%癥狀和體徵%偏性(流行病學)%雲南
    졸사%증상화체정%편성(류행병학)%운남
    Death,sudden%Symptome and signs%Bias(epidemiology)%Yunnan
    目的 探索云南不明原因猝死(SUD)的临床表现特点.方法 前瞻性的调查2005年发生在云南的不明原因猝死病例,分析了具有聚集性特征的7个家庭及相关病例的临床表现特点.结果 通过对2005年发病的7个发生聚集性猝死的家庭及其相关病例的调查资料,分析病例的临床特点.发现死者和同发病例除具有头晕、乏力、甚或反复晕厥等共同症状外,尤其采用恶心、呕吐、腹痛和腹泻的消化道症状将聚集性病例分为两大类:(1)具有消化道症状的聚集性死亡:多可以寻找到共同的可疑饮食史,或具有发病过程中类似的实验室指标(天冬氨酸转氨酶、肌酸激酶、乳酸脱氢酶等)剧烈升高到降低恢复的过程.(2)没有消化道症状的聚集死亡:这组聚集死亡和同发病例临床表现呈现多样化,首例死亡与续发死亡病例临床表现差异大,续发病例发病到死亡时间短,死亡前缺少或无症状.(3)能得到的心电图显示为显著的长Q-T间期和ST-T改变.结论 云南SUD具有时间、空间和人群高度聚集的特点,其中家庭/时间聚集性特征的猝死更是研究的主体,它很难用某一疾病来解释.其临床表现多样化,但可根据有无消化道症状粗分为两种不同特点的猝死.没有发现有遗传性疾病和(或)传染病的特征.由于其病因不明,故还需进行详细、深入的研究.
    목적 탐색운남불명원인졸사(SUD)적림상표현특점.방법 전첨성적조사2005년발생재운남적불명원인졸사병례,분석료구유취집성특정적7개가정급상관병례적림상표현특점.결과 통과대2005년발병적7개발생취집성졸사적가정급기상관병례적조사자료,분석병례적림상특점.발현사자화동발병례제구유두훈、핍력、심혹반복훈궐등공동증상외,우기채용악심、구토、복통화복사적소화도증상장취집성병례분위량대류:(1)구유소화도증상적취집성사망:다가이심조도공동적가의음식사,혹구유발병과정중유사적실험실지표(천동안산전안매、기산격매、유산탈경매등)극렬승고도강저회복적과정.(2)몰유소화도증상적취집사망:저조취집사망화동발병례림상표현정현다양화,수례사망여속발사망병례림상표현차이대,속발병례발병도사망시간단,사망전결소혹무증상.(3)능득도적심전도현시위현저적장Q-T간기화ST-T개변.결론 운남SUD구유시간、공간화인군고도취집적특점,기중가정/시간취집성특정적졸사경시연구적주체,타흔난용모일질병래해석.기림상표현다양화,단가근거유무소화도증상조분위량충불동특점적졸사.몰유발현유유전성질병화(혹)전염병적특정.유우기병인불명,고환수진행상세、심입적연구.
    Objective To investigate the clinical features of unexpected sudden death (SUD) clustered in families in Yunnan province.Methods This retrospective study analyzed the clinical features of SUD occurred between July to September 2005 in 7 families in Yunnan province.Results All 16 SUD patients shared common clinical features such as fatigue and repeated syncope and one group of SUD patients (n = 8 from 4 families) presented with the gastric intestinal tract manifestations including nausea, vomiting, abdominal pain and diarrhea with suspected dietary history and abnormal laboratory enzyme findings (GOT/ GPT,CK/CKMB,LDH/LDH1 etc.).In SUD patients without gastric intestinal tract manifestations (n = 8 from 3 families), there were no clear symptoms before death and repeated ventricular tachycardia and ventricular fibrillation were recorded in one survivor.There was no clear evidence for the involvements of hereditary and infectious factors for observed SUD.conclusion The reason for the unexpected sudden death clustered in 7 families in Yunnan remains unclear.Repeated syncope and fatigue served as the common clinical features in the presence or absence of gastric intestinal tract manifestations in all SUD cases.Further studies are needed to clarify the pathology and detailed clinical manifestations of SUD occurred in this area.
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