Objectives: To analyze the gross pathological data of sudden cardiac death (SCD) with different causes, to provide data support for the identification of sudden cardiac death with unknown causes.
Methods: A total of 167 adult SCD cases in the archive of the Forensic Expertise Institute of Nanjing Medical University from 2010 to 2020 were collected. The gross pathological data of SCD cases were summarized and the characteristics of different causes of death were statistically analyzed.
Results: The ratio of male to female SCD cases was 3.4∶1. Coronary heart disease was the leading cause of SCD, and mainly distributed in people over 40 years old. SCD caused by myocarditis was mainly distributed in young people and the mean age of death was (34.00±9.55) years. By analyzing the differences in cardiac pathological parameters of SCD with different causes, it was found that the aortic valve circumference was significantly dilated in the SCD caused by aortic aneurysm or dissection (P<0.05). The heart weight of SCD caused by aortic aneurysm or dissection and combined factors was greater, and both pulmonary and tricuspid valvular rings were dilated in the SCD caused by combined factors in adult males (P<0.05).
Conclusions: Various gross pathological measures of SCD with different causes are different, which has reference value in the cause of death identification of SCD.
目的: 分析不同原因心脏性猝死（sudden cardiac death，SCD）的大体病理学数据，为不明原因的猝死鉴定提供证据支持。方法: 收集南京医科大学司法鉴定所2010—2020年行法医病理鉴定的167例成人SCD案件，汇总SCD案例的大体病理学检验数据，统计分析不同死因的特征。结果: 男、女性SCD案例比例3.4∶1。冠状动脉粥样硬化性心脏病是引起SCD的首要原因，主要分布于40岁以上的人群。心肌炎导致的猝死主要分布于年轻群体，平均死亡年龄为（34.00±9.55）岁。分析不同原因SCD的心脏病理学参数差异发现，主动脉瘤或动脉夹层猝死者的主动脉瓣瓣环周径多呈明显扩张（P<0.05）。男性主动脉瘤或动脉夹层和合并死因组的心脏质量增大，合并死因组的肺动脉瓣和三尖瓣瓣环均扩张（P<0.05）。结论: 不同原因SCD存在多个大体病理学测量指标差异，在心脏性猝死的原因推断中具有参考价值。.
Keywords: aortic aneurysm; aortic dissection; cause of death; coronary atherosclerotic heart disease; forensic pathology; sudden cardiac death.