Analyze And Research About Clinical Examination And Detection Indexes Of Yunnan Sudden Unexplained Death

[Objective]Got through observe the electrocardiogram, blood biochemistry and physical examination about the population who lived in Yunnan sudden unexplained death (YSUD) major areas, new YSUD areas and control area. Then researched the characteristic of YSUD clinical examination and detection indexs. Analyze the index s'similarity and difference between YSUD cases and other population; Objective to know YSUD areas population health status, assessment population health risk. To further improve case report standard, diagnostic standard and cure standard, offer scientific basis for counter measure and etiology research.[Methods]From May to October 2007, we carried out six times consecutive observed about clinical examination and detection indexs in the three YSUD major areas, analyzed the health status and change situation. From 2005 to 2009, in new YSUD areas, we carried out investigation on clinical examination and detection indexs about YSUD case, concurrent case, family member, fellow villager, near villager, analyzed the population health status. In April and August 2009, choosed a control site:luohei village Yun county, It remarkably alike with YSUD areas in geography and land feature, financial position, custom and culture, etc. We carried out two times consecutive observed about clinical examination and detection indexs before epidemic stage and during epidemic stage, analyzed the population health status and developed comparative study. The major methods were descriptive study and ecology comparative study. Founded the data base by Epi Data and Excel software, analyzed the data by SPSS18.0 statistical software.[Results]1. The major change of clinical examination and detection indexs were electrocardiogram and myocardial enzyme to YSUD cases and concurrent cases. The types of the electrocardiogram to them were Q-T interval prolong (42.9%/25.0%), T wave abnormal (35.7%/37.5%), sinus tachycardia (35.7%/31.3%), ST-T alter (21.4%/18.8%), conduction block (14.2%/6.3%). The rate of abnormality of the myocardial enzyme was 100.0%, and the indexes of AST/ALT (100.0%/90.9%), CK (100.0%/64.3%), CK-MB (100.0%/78.6%), CK-MB/CK (100.0%/100.0%) were most obviously. The relevance ratio of electrocardiogram, the abnormality rate and mean value of myocardial enzyme, the relevance ratio of sinus tachycardia, YSUD cases were exceed to other population, but the relevance ratio of sinus bradycardia was inferior to other population.2. All types of population who lived in YSUD major areas and new areas, the relevance ratio of electrocardiogram was exceed to other population, U wave abnormal(44.5%/9.9%), T wave abnormal(10.6%/20.5%), ST-T alter(1.7%/11.6%), sinus tachycardia (0.9%/17.9%), Q-T interval prolong (0.9%/14.8%) were most obviously myocardial damage change. The risk of arrhythmia was higher. At the different times, the abnormality rate of blood biochemistry were myocardial enzyme (53.1%/57.9%)>>blood fat (23.5%/24.2%)> serum protein (9.4%/10.3%)> liver function (9.1%/9.9%)> renal function (8.8%/9.5%)> electrolyte (4.6%/4.6%). The myocardial enzyme was the most obviously abnormal blood biochemistry index. YSUD population's abnormality rate of myocardial enzyme was higher than control population. In the YSUD major areas, the relevance ratios of hypertension and sinus bradycardia were higher than control population. BMI value fell within the scope of normal reference to the YSUD major areas population and control population. The relevance ratio of thin of the YSUD major areas population was higher than control population. It showed that they had no statistical difference among other indexs.3. The relevance ratio of electrocardiogram, the abnormality rate and mean value of myocardial enzyme to new areas population had same trend:①Acute phase: YSUD case> concurrent case> family member> fellow villager> near villager> control population, that showed graded decrease.②Same population:acute phase> restoration phase.③The health status in restoration phase was close to control population level. It showed that they had no significant difference among other indexs.4. The health status of YSUD areas population maily embodied higher relevance ratio of electrocardiogram and abnormality rate of myocardial enzyme, the mean value of myocardial enzyme was also higher. The YSUD areas population's cardiac muscle was varying degrees damaged; there was difference about population and times.[Conclusions]1. YSUD cases mainly damaged organ was heart, YSUD cases arised from malignant arrhythmia. The mainly diagnose methods were electrocardiogram and myocardial enzyme, and the mainly treat means were arrhythmia corrected and cardiac resuscitation.2. The health status of YSUD areas population was bad, the relevance ratio of electrocardiogram and abnormality rate of myocardial enzyme were higher, and higher myocardial damage risk. It was possible that causative factor existe in the whole natural environment; It was different that individual was attacked by predisposing cause.3. Electrocardiogram and myocardial enzyme were specificity indexs to YSUD cases and concurrent cases; they were important reference to case definition and intervening measure; they were the important indexs to monitor the state of YSUD and the warning indexs of YSUD events; they were also the clue of etiology research.