【摘要】：目的：探討竇房結(jié)動(dòng)脈狹窄和竇房結(jié)內(nèi)纖維含量、脂肪含量的關(guān)系，明確竇房結(jié)動(dòng)脈狹窄與猝死的關(guān)系，，為竇房結(jié)內(nèi)病理性纖維化或脂肪浸潤(rùn)的發(fā)病機(jī)理及傳導(dǎo)系統(tǒng)病變的猝死機(jī)理提供理論基礎(chǔ)。揭示竇房結(jié)病理改變引起猝死的法醫(yī)病理學(xué)特征。 研究背景：多個(gè)案例報(bào)道心臟傳導(dǎo)系統(tǒng)動(dòng)脈管壁增厚、管腔狹窄引起猝死，伴或不伴有竇房結(jié)內(nèi)間質(zhì)含量增多。一項(xiàng)系統(tǒng)性研究揭示房室結(jié)動(dòng)脈病變?cè)谛脑葱遭澜M的狹窄程度明顯高于年齡匹配的外傷死亡組，提示傳導(dǎo)系統(tǒng)動(dòng)脈病變可能是猝死的原因之一。目前未見竇房結(jié)動(dòng)脈病變和猝死關(guān)系的系統(tǒng)研究。 方法：通過回顧性研究將符合納入標(biāo)準(zhǔn)的148例臨床表現(xiàn)為猝死或不明原因死亡者按照系統(tǒng)尸體解剖后確定的死亡原因分為傳導(dǎo)系統(tǒng)病變猝死組(59例，平均年齡32.10±12.76歲)、心臟疾病死亡組(41例，平均年齡46.51±13.84歲)和非心臟原因死亡組(48例，平均年齡33.31±15.16歲)。石蠟包埋的心臟竇房結(jié)組織連續(xù)切片分別進(jìn)行HE染色、Masson染色和彈力及膠原纖維雙色染色，應(yīng)用圖像分析技術(shù)檢測(cè)竇房結(jié)動(dòng)脈內(nèi)徑、內(nèi)外徑比、纖維含量和脂肪含量，觀察竇房結(jié)及心臟組織病理改變。采用國(guó)際通用的SPSS 11.5軟件包中構(gòu)成比、x~2檢驗(yàn)、方差分析等統(tǒng)計(jì)學(xué)方法進(jìn)
[Abstract]:Objective: to investigate the relationship between sinus node artery stenosis and fiber content and fat content in sinoatrial node, and to clarify the relationship between sinus node artery stenosis and sudden death. It provides a theoretical basis for the pathogenesis of pathological fibrosis or fat infiltration in sinoatrial node and the mechanism of sudden death in conduction system lesions. To reveal the forensic pathological features of sudden death caused by sinoatrial node pathological changes. Background: the thickening of arterial wall in cardiac conduction system, sudden death caused by stenosis of lumen, and the increase of interstitial content in sinoatrial node were reported in many cases. A systematic study revealed that the degree of stenosis of atrioventricular nodal artery lesions in the sudden cardiac death group was significantly higher than that in the age-matched traumatic death group, suggesting that the arterial lesion of the conduction system may be one of the causes of sudden death. At present, there is no systematic study on the relationship between sinus node artery disease and sudden death. Methods: 148 cases of sudden or unknown death were divided into sudden death group (59 cases) and sudden death group (59 cases) according to the causes of death determined after systematic autopsies. The mean age was 32.10 鹵12.76 years old, 41 patients died of cardiac disease (mean age 46.51 鹵13.84 years) and 48 patients died of non-cardiac causes (mean age 33.31 鹵15.16 years). The paraffin embedded sections of sinoatrial node were stained with HE, Masson, elastic and collagen fibers respectively. The internal diameter, internal / external diameter ratio, fiber content and fat content of sinoatrial node artery were measured by image analysis technique. The sinoatrial node and the pathological changes of cardiac tissue were observed. The statistical methods such as composition ratio, x ~ (2) test, variance analysis and so on are adopted in the SPSS 11.5 software package, which is widely used in the world.
【學(xué)位授予單位】：四川大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：D919.1

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