【摘要】 目的探讨病毒性心肌炎(viralmyocarditis,VCM)和扩张型心肌病(dilatedcardiomyopathy,DCM)的发病机制及相互关系,从而提高心性猝死法医学鉴定的可靠性和准确性。方法对17例对照组(包括冠心病、高血压性心脏病和正常心脏等),25例VCM和28例DCM的心肌组织进行改良的β-sarcoglycan免疫组织化学染色观察,并对其阳性反应率进行χ2检验及相关分析。结果β-SG蛋白在对照组,VCM组和DCM组中阳性反应率分别为100%,80%,46.4%。经χ2检验,3组阳性反应率差异有显著性意义(P<0.05);用χ2分割法分析,VCM和DCM组间差异有显著意义(P<0.05),且Spearman等级相关分析呈显著负相关(rs=-0.605)。结论病毒性心肌炎和扩张性心肌病病变与β-SG的被破坏有关;随着VCM病变程度的加重,其可能发展为DCM。更多还原

【Abstract】 Objective In order to improve the accuracy and reliability of sudden cardiac death in the medicolegal expertise, it was investigated to the pathogenesis and relationship between the viral myocarditis and dilated cardiomyopathy. Methods Improved immunohistochemical staining technique was adopted to detect the expression of the β-sarcoglycan(β-SG) in the myocardia in 25 cases of VCM, 28 cases of DCM and 17 cases of control group. Results The positive rate of β-SG protein expression was 100% in control group; 80%, in VCM; and 46.4%, in DCM. The positive rate had significant difference among three groups (P<0.05), and there was significant correlation between VCM and DCM group(r_s=- 0.605 ).Conclusion The disruption of myocardial β-SG protein in VCM and DCM may be involved in the pathogenesis of VCM and DCM. These abnormalities have relationship to the development from VCM to DCM.更多还原