心肌梗死和心脏传导系统病变在心源性猝死中的作用

摘要

Sudden cardiac death (SC D ),m ostcom m only seen in coronary heart disease, is a kind of sud-den death caused by series of cardiac param eters, w hich usually com bines w ith m yocardial infarction. H ow ever, som e SC D s (including early m yocardial infarction) happen suddenly and cause death in a very short tim e. In these circum stances, typical m orphological changes are lack in m acroscopic or m icroscopic fields, w hich m ake such SC D s becom e the em phasis and difficulty in the present research. SC D caused by m yocardial infarction and abnorm alities of cardiac conduction system (C C S ) is related to atheroscle-rosis of coronary artery closely. T his paper review s cardiac dysfunction caused by m yocardial infarction and diseases of C C S from m orphology and m olecular biology, and explores potential relationship be-tw een them . T his paper aim s to provide clues to the m echanism of m yocardial infarction related sudden death and possible assistance for forensic diagnosis of SC D .%心源性猝死(sudden cardiac death,SCD)是由心脏原因引起的突然死亡,最常见于冠心病,且很多合并心肌梗死.但某些SCD(包括早期心肌梗死)由于发生突然,在极短的时间内即可引起死亡,肉眼和镜下缺乏典型的形态学改变,是目前研究的重点及难点.心肌梗死与心脏传导系统(cardiac conduction system,CCS)异常引起SCD的原因都与冠状动脉粥样硬化密切相关,本文从形态学和分子生物学两个方面入手,对心肌梗死与CCS病变引起心脏功能障碍的相关研究进行综述,以进一步揭示两者之间的相关性,对今后心肌梗死引起猝死机制方面的研究提供线索,为SCD的法医学诊断提供帮助.