Establishment of diagnostic criteria of cardiac diseases in the cases of sudden infant death

本文对24例1岁以下婴儿猝死进行了系统检查。24例心脏肉眼可见异常5例，其中完全性肺静脉异位引流1例，主动脉窦瘤2例，主动脉缩窄2例。1例窦瘤，Valsalva同时显示房间隔缺损和动脉导管未闭。镜下表现为肥厚型心肌病2例，局灶性心肌梗塞2例，风湿性心肌炎1例，细胞心肌炎1例。心传导系统异常旁路12例。24例中11例表现为延髓弓状核成形性或成形性减退，8例为传导系统异常旁路连接。脑干异常、俯卧位睡眠、心脏异常3种因素均有7例，2种异常6例。我们的结果表明，睡眠姿势异常与沉默的心脏和脑干异常重叠有额外的婴儿猝死风险。

Twenty four cases of sudden infant death under lyear old were examined systematically. Five of 24 cases showed macroscopic cardiac abnormality, which were total anomalous pulmonary venous connection (1 cases), aneurysm of sinus valsalva (2 cases), and coactation of aorta (2 cases). In a case of aneurysm of sinus valsalva showed also atrial septal defect and patatent ductus arteriosus. In microscopically, two cases showed hypertrophic cardiomyopathy, and focal myocardial infarction, respectively, and a case of rheumatic myocarditis, cytomegello myocarditis, was found respectively. In cardiac conduction system, 12 cases showed anomalous accessory connection,. Eleven of 24 cases showed aplasty or hypoplasty of medullary arcuate nucleus, and 8 of 12 cases had anomalous accessory connection in conduction system. And also, 7 cases showed all 3 factors which are brain stem abnormality, prone positioned sleeping, cardiac abnormality, and 6 cases showed 2 kind of abnormal findings. Our results showed overlapping of abnormalities of sleeping position with silent cardiac and brain stem abnormalities have the additional risk of sudden infant death.