【摘要】：背景及目的:SCD 檢驗鑒定是法醫(yī)病理學(xué)中的常見問題之一。心肌缺血被認為是 SCD 的重要原因,但 SCD 肉眼檢查及常規(guī)組織病理學(xué)檢查心肌梗死灶檢出率很低,尋找可在心肌組織上靈敏表達的早期心缺血指標,成為 SCD 研究課題的重點及難點。但對可導(dǎo)致 SCD 發(fā)生的非缺血因素以及 SCD 發(fā)生機制卻研究很少。ANP、BNP 屬心臟的神經(jīng)內(nèi)分泌激素,對循環(huán)血量、電解質(zhì)、血管等具有調(diào)節(jié)作用,其血漿水平能反映心臟功能狀況,在可導(dǎo)致 SCD 的多因素(缺血性和非缺血性)中,利鈉肽均具有良好相關(guān)性。本實驗利用尸檢心肌標本,應(yīng)用免疫組織化學(xué)方法檢測 ANP、BNP 在 SCD 組心肌、非 SCD 心肌、非 SD 正常心肌中的表達情況,初步探討 NP 在法醫(yī)學(xué)診斷 SCD 的價值。 方法:1.選材: 選取法醫(yī)教研室 2000 年至 2004 年尸檢心臟標本36 例,其中男性 21 人,女性 15 人,平均年齡 44.9 歲,(具體年齡構(gòu)成見表 1)按以下標準分為 3 組:(1).SCD 組 12 例(A 組),其中冠狀動脈硬化性心臟病(冠狀動脈Ⅲ°以上狹窄)未伴明顯梗死灶 4 例,心肌病 4 例,心肌炎 4 例,以上均經(jīng)肉眼和顯微鏡同時證實,符合診斷標準,其它系統(tǒng)沒有檢見嚴重器質(zhì)性疾病,法醫(yī)病理學(xué)診斷為 SCD;(2)非 SCD組 12 例(B 組),其中腦出血 4 例, 肺栓塞 4 例,急性腹膜炎 4 例,其中在肉眼和顯微鏡中心臟均未檢見較重器質(zhì)性疾病.在(1)(2)兩組,均為平素身體貌似健康,突然發(fā)病所致,從發(fā)病到死亡在 24 小時以內(nèi).(3)非 SD正常心肌組 12 例(C 組),即因心臟外疾病死亡,從發(fā)病到死亡在 48 小
[Abstract]:Background & objective: SCD examination and identification is one of the common problems in forensic pathology. Myocardial ischemia is considered to be an important cause of SCD, but the detection rate of myocardial infarction by SCD naked eye examination and routine histopathological examination is very low, so it is necessary to search for early myocardial ischemia markers that can be sensitively expressed in myocardial tissue. It has become the focus and difficulty of SCD research. However, there are few studies on the non-ischemic factors and the mechanism of SCD. BNP, a neuroendocrine hormone of the heart, can regulate the circulation blood volume, electrolytes and blood vessels, and its plasma level can reflect the state of the heart function, and its plasma level can reflect the state of the heart function, and its plasma level can reflect the state of the heart function. Natriuretic peptides are well correlated in the multiple factors (ischemic and non-ischemic) that can lead to SCD. In this study, the expression of ANP,BNP in myocardium of SCD group, non-SCD myocardium and normal myocardium of non-SD was detected by immunohistochemical method, and the value of NP in forensic diagnosis of SCD was discussed. Methods: 1. Material selection: from 2000 to 2004, 36 autopsy heart specimens were selected from the Forensic Laboratory, including 21 males and 15 females, with an average age of 44.9 years. (see Table 1) divided into 3 groups according to the following criteria: (1) 12 cases in). SCD group (group A), including 4 cases of coronary sclerosing heart disease (stenosis of coronary artery above 鈪，

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