据报道,青少年在运动中或老年人在睡眠中的急死主要与缺血性心脏病、心律失常导致的心脏性死亡有关。实际上,多数猝死的原因尚不明确。但住院患者的猝死与上述猝死不同,前者由于存在基础疾病,故其猝死的原因可能与基础疾病有关,往往可以搞清楚。本文对东京都监察医务院猝死病人的死因进行了分析,并与日本医大第一内科住院的猝死病人作比较,同时就引起社会关注的心血管疾病高危病人如何预测等问题概述如下。一、东京都监察医务院猝死病人的死因分析经对839例猝死病人的剖检结果表明,死因为心血管系疾病者高达550例(65.6%),其中缺血性心脏疾病418例(76%)占半数以上,主动脉破裂81例(14.7%),其它心脏疾病(原发性心肌病、原发性心肌炎、高血压性心肌肥大瓣膜病等)51例(9.3%)。此外还有脑血管疾 It has been reported that the acute death of adolescents during exercise or in the elderly is mainly associated with cardiac death due to ischemic heart disease and arrhythmia. In fact, the cause of most sudden death is not yet clear. However, sudden death in hospitalized patients is different from the above sudden death, the former due to the existence of underlying diseases, so the cause of sudden death may be related to underlying diseases, often can be clear. This article analyzes the causes of death from sudden death in the Tokyo Metropolitan Police Hospital and compares them to the sudden death in hospital in Japan’s First Medical University. At the same time, we outline the following issues on how to predict the high-risk patients with cardiovascular diseases that cause social concern. First, the Tokyo Metropolitan Institute of Surveillance of sudden death in patients with sudden death analysis of 839 cases of sudden death of the patient’s autopsy results showed that the cause of death as a cardiovascular disease as many as 550 cases (65.6%), of which 418 cases of ischemic heart disease (76% ) Accounted for more than half, 81 cases of aortic rupture (14.7%), other heart disease (primary cardiomyopathy, primary myocarditis, hypertensive myocardial hypertrophy valvular disease, etc.) in 51 cases (9.3%). In addition there are cerebrovascular disease