突然死を防ぐために(夏に気をつけること)

2016年7月15日号

櫻井岳史(桜井内科医院)

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 突然死とは、急性症状を認めてから24時間以内の死亡で、外因死(事故死など)を除いた自然死(病死)のことをいいます。原因がわかるものでは、心臓・大血管系疾患が七割以上を占め、次いで脳血管系疾患が続きます。代表的な疾患は心筋梗塞や脳梗塞で、春や秋に比べて夏季にはその発生率が上昇します。
 気温の上昇で発汗量が増加すると、血管内は水分不足(脱水状態)になり、 血液が固まりやすくなります。そして何らかの要因で血管内に血の塊(血栓)を生じ、それが重要な血管に詰まって諸々の病気を引き起こします。
 心蔵の筋肉を栄養する血管(冠状動脈)が詰まると心筋梗塞、脳の血管が詰まると脳梗塞となります。また、先日の熊本地震でも話題になりましたが、脱水や運動不足で脚の血管に血栓を生じ、それが肺の血管に流れ詰まって呼吸困難などを起こす深部静脈血栓症・肺動脈塞栓症も突然死の原因として重要です。
 ご高齢の方や、高血圧症、脂質異常症、動脈硬化症、糖尿病などの慢性疾患がある方は一般に内臓機能が低下しています。そのため体内の水分量や塩分・ミネラルなどの自己調節能力が衰えています。
tadalafil citrate  そのため、例えば腎機能が低下した方が脱水症・熱中症になると充分な尿量が確保できず、体内に老廃物がたまった状態(尿毒症)となります。適切な治療を受けないと不整脈発作や多臓器不全を引き起こし、これも突然死につながります。しかし、過剰に水分を摂取すると体がむくみ、心不全・呼吸困難を引き起こす場合もあります。ですので、現在病気治療中の方は、適切な水分摂取について担当医とよく相談しておくことをお勧めします。

 普段から特定健診、後期高齢者健診を受診し、生活習慣病の予防、早期発見に努めておく。病気が発見されれば適切な治療を受け、内臓障害の進行を抑制する。夏季においては気温・湿度の上昇に注意し積極的にエアコンなどを活用し、脱水症・熱中症を防止することが突然死予防につながります。