QUANTITATIVE AMOUNTS OF CORONARY NARROWING IN COCAINE ADDICTS

从1979年1月到1989年2月，我们研究了尸检22号可卡因 瘾君子。将22例患者分为两组：可卡因致死组 服药过量(13名患者，年龄23-45岁(平均32岁)，平均全血 可卡因水平，0.36 mg/dl)和非可卡因相关死亡(9名患者，老年人 15到50年[平均32年])。在22名患者中，17名为男性，5名为 女性；19名黑人，3名白人。22例患者大体检查结果分析 8例患者(36%)有4个主要分支中的一个或多个(左主干， 左前降支、左回旋支和右)冠状动脉 动脉粥样硬化使横截面积缩小75% 斑块。心外膜冠状动脉4条主干分离17例 进入805例5 mm长中毒患者的血药浓度可卡因 在尸检中，544个5 mm冠状动脉节段中有41个(8%)狭窄到76个 分别有100%和106个节段(19%)横截面积缩小51~75% 通过斑块。5名与死亡无关的可卡因成瘾者 可卡因使用，261个5毫米冠状动脉节段中有8个(3%)缩小到76个 截面积缩小51~75%者分别为100%和19个节段(7% 通过斑块。这些发现表明，冠状动脉的频率 在服用可卡因后不久死亡的患者中，狭窄程度更大 与那些不是死于可卡因过量的人相比。也就是 严重冠状动脉狭窄的频率要高得多 比平均年龄只有32岁的整组患者的预期要好 好几年了。

From January 1979 to February 1989, we studied at necropsy 22 cocaine addicts. The 22 patients were divided into 2 groups: death due to cocaine overdose (13 patients, aged 23 to 45 years(mean 32], and mean total blood cocaine level, 0.36 mg/dl) and non-cocaine related death (9 patients, aged 15 to 50 years [mean 32]). Of the 22 patients, 17 were men and 5 were women; 19 were black and 3 were white. Gross examination in the 22 patients disclosed that 8 patients (36%) had 1 or more of the 4 major (left main, left anterior descending, left circumflex, and right) coronary arteries narrowed at some point >75% in cross-sectional area by atherosclerotic plaque. In 17 cases, the 4 major epicardial coronary arteries were divided into 805 five-mm long patients with toxic blood concentrations of cocaine at necropsy, 41 (8%) of 544 five-mm coronary segments were narrowed 76 to 100% and 106 segments (19%) were narrowed 51 to 75% in cross-sectional area by plaque. Of the 5 cocaine addicts in whom death was not related to cocaine use, 8 (3%) of 261 five-mm coronary segments were narrowed 76 to 100% and 19 segments (7%) were narrowed 51 to 75% in cross-sectional area by plaque. These findings suggest that the frequency of coronary artery narrowing is greater in patients who die shortly after taking cocaine compared to those with death not due to cocaine overdose. Also the frequency of severe coronary arterial narrowing is considerably greater than expected for the entire group of patients whose mean age was only 32 years.