法医学杂志

法医学杂志 ›› 2021, Vol. 37 ›› Issue (2): 225-232.DOI: 10.12116/j.issn.1004-5619.2020.400820

• 综述 • 上一篇    下一篇

窦房结病理性纤维化的研究进展

王威1， 张世林1， 刘芳芳1， 方婷1， 刘思豆1， 王春平2， 幸宇3， 刘云1， 金波1   

  1. 1. 川北医学院法医学系，四川 南充 637000； 2. 射洪市公安局，四川 射洪 629200； 3. 重庆医科大学法医学教研室，重庆 400016
  • 收稿日期:2020-08-24 发布日期:2021-04-25 出版日期:2021-04-28
  • 通讯作者: 金波，男，博士，教授，主要从事法医学教学、科研和鉴定；E-mail：jinbo@nsmc.edu.cn
  • 作者简介:王威（1993—），男，硕士研究生，主要从事法医学研究；E-mail：wangwei19931120@163.com
  • 基金资助:
    四川省科技厅应用基础研究面上资助项目（2018JY0497）；2019年法医病理学公安部重点实验室开放课题资助项目（GAFYBL201904）；川北医学院博士科研启动基金资助项目（CBY16-QD05）；南充市市校合作科研专项资金项目（19SXHZ0197）；2020年四川省大学生创新训练项目（S202010634082，S202010634222）

Research Progress on Pathological Fibrosis of Sinoatrial Node

WANG Wei1, ZHANG Shi-lin1, LIU Fang-fang1, FANG Ting1, LIU Si-dou1, WANG Chun-ping2, XING Yu3, LIU Yun1, JIN Bo1#br#   

  1. 1. Department of Forensic Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China; 2. Shehong Public Security Bureau, Shehong 629200, Sichuan Province, China; 3. Department of Forensic Medicine, Chongqing Medical University, Chongqing 400016, China
  • Received:2020-08-24 Online:2021-04-25 Published:2021-04-28

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摘要： 人类心脏节律主要受窦房结调控，纤维化对窦房结起搏复合体的结构和功能完整性有重要调节作用。在生理状态下，窦房结中纤维化的量与心率呈负相关，与年龄、心脏大小呈正相关，并可维持心率相对稳定。窦房结病理性纤维化可能导致不同类型的心律失常引起猝死。明确窦房结病理性纤维化相关机制将为临床治疗窦房结纤维化提供靶点，也可为法医病理学工作者提供诊断依据。本文回顾了窦房结病理性纤维化的主要机制，包括窦房结内心脏成纤维细胞异常激活、心外膜脂肪组织增生、钙钟紊乱、血管狭窄等，介绍其检验方法、诊断标准及在心脏性猝死中的作用，探讨其潜在的应用领域，为相关研究、应用提供参考。

关键词: 法医病理学, 窦房结, 纤维化, 猝死, 综述

Abstract: Human heart rhythm is mainly regulated and controlled by the sinoatrial node. Fibrosis plays an important regulating role in adjusting the structural and functional integrity of the sinoatrial node pacemaker complex. In physiological state, the fibrosis degree of sinoatrial node is negatively correlated with heart rate, positively correlated with age and heart size, and can maintain a relatively stable heart rate. Pathological fibrosis of sinoatrial node can induce various types of arrhythmias which can result in sudden death. Determination of the mechanisms related to sinoatrial node pathological fibrosis could provide a target for clinical treatment of sinoatrial node fibrosis and diagnosis basis for forensic pathologists. This paper reviews the main mechanism of sinoatrial node pathological fibrosis, including abnormal activation of cardiac fibroblast cells in sinoatrial node, hyperplasia of epicardial adipose tissue, calcium clock disorder, artery stenosis, etc., introduces the test methods, diagnostic criteria as well as its role in sudden cardiac death and discusses the potential application, to provide reference for relevant research and application.

Key words: forensic pathology, sinuatrial node, fibrosis, sudden death, review

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