本文選題：法醫(yī)病理學(xué)　切入點(diǎn)：早期心肌梗死　出處：《重慶醫(yī)科大學(xué)》2006年碩士論文　論文類型：學(xué)位論文

【摘要】： 背景:SCD的研究是法醫(yī)學(xué)最重要的任務(wù)之一,而EMI的死后診斷是其重點(diǎn)和難點(diǎn)。不足6h的心肌梗死,在肉眼和顯微鏡下均無(wú)特異性改變;不使用特殊的方法,是不可能作出EMI的組織學(xué)診斷并把其作為猝死原因的。在常規(guī)HE染色出現(xiàn)特征性形態(tài)學(xué)改變以前,缺血心肌已發(fā)生了一系列病理生理變化。生物化學(xué)方法,組織化學(xué)、酶組織化學(xué)、熒光組織化學(xué)染色,電子顯微鏡技術(shù),能夠顯示早期心肌損害。但是上述方法或因操作過于復(fù)雜而不利于常規(guī)使用,或因缺乏特異性、以及易受組織自溶、腐敗等因素的影響,而限制了它們?cè)诜ㄡt(yī)學(xué)實(shí)踐中的應(yīng)用。此前有研究表明,cTnT和VEGF的IHC染色是顯示心肌缺氧可靠和敏感的方法,可望用于由心肌缺血引起的SCD的死后診斷。用于EMI死后診斷的IHC指標(biāo)能否應(yīng)用于法醫(yī)學(xué)實(shí)踐,除了需要考慮其特異性和敏感性外,還必須考慮組織自溶、腐敗等因素對(duì)抗原的影響。目前,用于EMI死后診斷的各種IHC指標(biāo)的死后穩(wěn)定性及其在死后不同時(shí)間的表達(dá)變化規(guī)律是值得進(jìn)一步研究的重點(diǎn)。 目的:本研究用冠狀動(dòng)脈左前降支結(jié)扎的方法建立家兔急性心肌缺血模型,檢測(cè)心肌中VEGF和cTnT兩項(xiàng)免疫組化指標(biāo)在死后不同時(shí)間的表達(dá)情況,旨在探尋其死后穩(wěn)定性及表達(dá)的變化規(guī)律,以期對(duì)其在法醫(yī)學(xué)實(shí)踐中診斷EMI的應(yīng)用價(jià)值進(jìn)行評(píng)價(jià)。 方法:選取健康成年新西蘭兔12只,雌雄不限,體重2500g—3000g,隨機(jī)分為對(duì)照組和實(shí)驗(yàn)組。對(duì)照組兔直接處死,取左心室心肌;
[Abstract]:Background: the study of EMI is one of the most important forensic studies of Ren Wuzhi, and the postmortem diagnosis of EMI is its key and difficult point. After less than 6 hours of myocardial infarction, there is no specific change under the naked eye and microscope; no special methods are used. It is impossible to make a histologic diagnosis of EMI and use it as a cause of sudden death. Before the characteristic morphological changes in routine HE staining, a series of pathophysiological changes had taken place in ischemic myocardium. Enzyme histochemistry, fluorescent histochemical staining, electron microscopy can show early myocardial damage. But these methods are either too complex to be used routinely, or because of lack of specificity and vulnerability to tissue autolysis, The influence of factors such as corruption limits their application in forensic practice. Previous studies have shown that IHC staining of cTnT and VEGF is a reliable and sensitive method for showing myocardial hypoxia. It is expected to be used in the postmortem diagnosis of SCD caused by myocardial ischemia. Whether the IHC markers used in the postmortem diagnosis of EMI can be applied to forensic practice should not only be considered for its specificity and sensitivity, but also for tissue autolysis. At present, the postmortem stability of various IHC markers used for postmortem diagnosis of EMI and their expression changes at different postmortem times are worthy of further study. Objective: to establish a rabbit model of acute myocardial ischemia by ligating the left anterior descending coronary artery, and to detect the expression of VEGF and cTnT in myocardium at different time after death. The purpose of this study was to explore the changes of postmortem stability and expression of EMI and to evaluate its application in forensic practice. Methods: twelve healthy adult New Zealand rabbits, male and female, weighing 2500g-3000g, were randomly divided into two groups: the control group and the experimental group. The rabbits in the control group were killed directly and the left ventricular myocardium was taken.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：D919

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本文編號(hào)：1581311