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目的:了解肺心病猝死病因。方法:分析1980年至1998年我院住院7例肺心病猝死患者。结果:①猝死患者肺动脉平均压在(mPAP)均>30mmHg(1mmHg=0.1333kPa),全肺血管阻力(TVR)增加为113.4±32.6kPa·S~(-1)·L(-1),心排量(CI)减少2.47±0.72L·min~(-1)·m~(-2)。②存在气道明显阻塞,合并Ⅱ型呼衰,伴有氧代谢障碍。③7例患者1例合并阻塞性夜间睡眠呼吸暂停(OSA),1例经尸检证实合并肺血管栓塞及肺梗塞。④死亡时间以凌晨较多,2～6时4例,8～10时1例,14～16时2例,其中熟睡时5例。结论:肺动脉压力显著增高,气道阻塞明显伴有OSA以及活动较少的患者,可能为肺心病猝死的高危人群。
Objective: To understand the etiology of sudden cardiac death. Methods: From 1980 to 1998 in our hospital 7 cases of sudden death of patients with pulmonary heart disease. Results: ①The mean pulmonary artery pressure (mPAP) in patients with sudden death was> 30mmHg (1mmHg = 0.1333kPa) and the total pulmonary vascular resistance (TVR) increased to 113.4 ± 32.6kPa · S -1 (-1) Displacement (CI) decreased by 2.47 ± 0.72L · min -1 (m -2). ② obvious obstruction of airway, combined with type Ⅱ respiratory failure, accompanied by oxygen metabolism disorders. One patient had obstructive nocturnal sleep apnea (OSA) in one of seven patients, and pulmonary embolism and pulmonary infarction confirmed by autopsy in one patient. The death time in the early morning more, 2 to 6 in 4 cases, 8 to 10 in 1 case, 14 to 16 in 2 cases, of which 5 cases of sleeping. CONCLUSIONS: Pulmonary artery pressure is significantly increased, airway obstruction is significantly associated with OSA and less active patients and may be at high risk of sudden death from cor pulmonale.