【作者】 谢英；

【导师】 易旭夫；

【作者基本信息】 四川大学 ， 法医学， 2006， 硕士

【摘要】 目的：探讨窦房结动脉狭窄和窦房结内纤维含量、脂肪含量的关系，明确窦房结动脉狭窄与猝死的关系，为窦房结内病理性纤维化或脂肪浸润的发病机理及传导系统病变的猝死机理提供理论基础。揭示窦房结病理改变引起猝死的法医病理学特征。 研究背景：多个案例报道心脏传导系统动脉管壁增厚、管腔狭窄引起猝死，伴或不伴有窦房结内间质含量增多。一项系统性研究揭示房室结动脉病变在心源性猝死组的狭窄程度明显高于年龄匹配的外伤死亡组，提示传导系统动脉病变可能是猝死的原因之一。目前未见窦房结动脉病变和猝死关系的系统研究。 方法：通过回顾性研究将符合纳入标准的148例临床表现为猝死或不明原因死亡者按照系统尸体解剖后确定的死亡原因分为传导系统病变猝死组(59例，平均年龄32.10±12.76岁)、心脏疾病死亡组(41例，平均年龄46.51±13.84岁)和非心脏原因死亡组(48例，平均年龄33.31±15.16岁)。石蜡包埋的心脏窦房结组织连续切片分别进行HE染色、Masson染色和弹力及胶原纤维双色染色，应用图像分析技术检测窦房结动脉内径、内外径比、纤维含量和脂肪含量，观察窦房结及心脏组织病理改变。采用国际通用的SPSS 11.5软件包中构成比、x~2检验、方差分析等统计学方法进更多还原

【Abstract】 Objective: This study was undertaken to explore the relationship between the narrowing of sinus node(SN) artery and the fatty content or/and fibra content of SN. And to determine whether thickening of the SN artery is a cause of sudden cardiac death. And to explore the forensic pathology characteristics of sudden death caused by SN disease.Background: Most reported cases of sudden death attributed to thickening of the SN artery and/or atrioventricular(AV) node artery are not with necrosis of the cardiac conduction system (CCS). Part of them were reported of fibrosis or fatty infiltration in association with this finding. One control study was reported that by comparing the AV artery node in sudden unexplained with control subjects, the author demonstrated a quantitative difference between the degree of AV node artery narrowing in both groups. However the role of the SN artery are not fully understood in sudden death yet.Method: By retrospective study we analyzed 148 cases which are assessed at the School of Forensic Medicine from 1990 to 2005. The SN artery in 59 patients with sudden death caused by SN disease (mean age 32.10± 12.76 year) and in 41 patients with sudden cardiac death (mean age 46.51±13.84 year) were更多还原