云南不明原因心源性猝死致病危险因素回顾性调查

目的 探讨可能引起云南不明原因心源性猝死的致病危险因素,为进一步开展病因研究提供线索,为制定确实有效的预防控制措施提供科学依据.方法 在全省22个疫区县(市、区)和10个对照县(市)开展1978～2004年的不明原因猝死病例和同发病例的回顾性调查,疑似猝死病例的搜索调查,将调查资料核实整理后进行致病危险因素Logistic回归分析. 结果共调查云南230例不明原因心源性猝死病例,13例同发病例,68例非云南不明原因心源性猝死病例.34个可疑因素中筛选出人均年收入为保护性因素(OR0.432, 95%CI为0.299, 0.817).性别(OR5.018,95%CI为1.327, 18.353)、居住地海拔(OR1.002, 95%CI为1.000, 1.004)、血清CVB-IgM(OR3.290, 95%CI为1.990,7.653)、哭丧(OR4.380, 95%CI为1.177, 8.815)和上山采野生菌(OR3.375, 95%CI为1.160, 6.880)为致病危险因素.结论 云南不明原因心源性猝死的发生可能与性别、病区群众生活水平的高低、特定海拔范围内的地质、气候条件、肠道病毒感染、发病前有无受到强烈精神刺激、上山采野生菌是否接触过高致病性危险因素等有关.

Retrospective Investigation on Risk Factors of Unexpected Sudden Cardiac Death in Yunnan, China

Objective Discussing risk factors of unexpected sudden cardiac death(USUD) in Yunnan Province,providing the scientific basis for control and prevention.Methods Investigation on the USUD cases and simultaneously cases was carried out to search resemble cases in 22 counties and 10 control counties in Yunnan Province from 1978 to 2004.The result was made Logistic regressive analysis of risk factors after checking the investigated data.Results There were total of 231 cases with Yunnan unexpected cardiac sudden death,13 simultaneous cases,68 cases of non-USUD.Out of 34 suspicious factors,there were the yearly income per person of protective factor(OR=0.432,95%CI:[0.299,0.817]);Sex(OR=5.018,95%CI:[1.327,18.353 ]),height of habitation(OR=1.002,95%CI:[1.000,1.004]),serum CVB-IgM(OR=3.290,95%CI:[1.990,7.653]),weep(OR=4.380,95%CI:[1.177,8.815]) and picking wild mushroom(OR=3.375,95%CI:[1.160,6.880]) of risk factors.Conclusions USUD is probably concerned with the sex,living condition,geology,climate,enterovirus infection,stress,the risk factors exposure in moutains and so on.