法医学杂志

法医学杂志 ›› 2012, Vol. 28 ›› Issue (3): 167-171.DOI: 10.3969/j.issn.1004-5619.2012.03.002

• 论著 • 上一篇    下一篇

血清总IgE、类胰蛋白酶和类糜蛋白酶在药物过敏性休克死亡鉴定中的应用

王红杰1，宋纬平2，阳  宇3，黄京璐4，郝  博4，高  迪4，汤大为4，王小广4，刘水平4，权  力4，罗  斌4   

  1. （1.中山市公安局小榄分局，广东 中山 528415； 2. 中山市公安局东升分局，广东 中山 528414； 3. 广东省中医院病理科，广东 广州 510120； 4. 中山大学中山医学院法医学系，广东 广州 510080）
  • 发布日期:2012-06-25 出版日期:2012-06-28
  • 通讯作者: 罗斌，男，主任法医师，硕士研究生导师，主要从事法医病理学研究；E-mail：luobin@mail.sysu.edu.cn
  • 作者简介:王红杰（1982—），男，河南郑州人，主要从事法医病理学研究；E-mail：sidayang@sina.com
  • 基金资助:

    国家自然科学基金资助项目（39700167）

Application of Serum Total IgE, Tryptase and Chymase in the Identification of Death Caused by Drug Anaphylactic Shock

WANG HONG-JIE1, SONG WEI-PING2, YANG YU3, HUANG JING-LU4, HAO BO4, GAO DI4, TANG DA-WEI4, WANG XIAO-GUANG4, LIU SHUI-PING4, QUAN LI4, LUO BIN4   

  1. （1. Xiaolan Branch of Zhongshan Public Security Bureau, Zhongshan 528415, China; 2. Dongsheng Branch of Zhongshan Public Security Bureau, Zhongshan 528414, China; 3. Pathology Department of GuangDong Provincial Hospital of TCM, Guangzhou 510120, China; 4. Department of Forensic Medicine, Zhongshan Medical College, Sun Yat-sen University, Guangzhou 510080, China）
  • Online:2012-06-25 Published:2012-06-28

被引次数

17

摘要： 目的 探讨血清总IgE、类胰蛋白酶和类糜蛋白酶表达在药物过敏性休克死亡鉴定中的应用价值。 方法 分析已检测IgE水平案例中非过敏致死案例（235例）和药物过敏性休克致死案例（32例）的基本临床资料，选取非药物过敏案例中冠心病致死和青壮年猝死综合征致死各10例为对照组，应用免疫组织化学法对药物过敏性休克组和对照组肺和心肌组织中的类胰蛋白酶与类糜蛋白酶表达进行检测，计算阳性肥大细胞数及积分光密度值。 结果 药物过敏性休克组中18例（56.25%）血清总IgE值明显高于正常值上限120 IU/mL，非过敏性休克案例中67例（28.51%）高于120 IU/mL。药物过敏性休克组肺与心肌组织中的类胰蛋白酶和类糜蛋白酶的表达均升高（P＜0.05）。 结论 在药物过敏性休克死亡案件的鉴定中，类胰蛋白酶、类糜蛋白酶的免疫组织化学检测比血清总IgE有更大的优势，更适合在实际检案中应用。

关键词: 法医病理学, 过敏反应, 免疫球蛋白E, 类胰蛋白酶, 类糜蛋白酶

Abstract: Objective To explore the application value of serum total IgE, tryptase and chymase in the identification of death caused by drug anaphylactic shock. Methods The general information from 235 cases of non-drug anaphylactic shock and 32 cases of drug anaphylactic shock were analyzed. The serum IgE level had been detected in the cases. Ten cases caused by coronary disease and 10 cases caused by sudden manhood death syndrome were selected from non-drug anaphylactic shock cases for the control group. Expressions of tryptase and chymase in the lung and heart were detected using immunohistochemistry method. The number and IOD of positive mast cells were counted. Results In the drug anaphylactic shock group, the IgE value of 18 samples（56.25%） was significantly higher than the normal upper limit of 120 IU/mL. In the non-drug anaphylactic shock group, the IgE value of 67 samples（28.51%） was higher than 120 IU/mL. The expressions of tryptase and chymase were significantly increased in lung and myocardial tissue in drug anaphylactic shock group（P＜0.05）. Conclusion Tryptase and chymase are more superior than that of the serum total IgE in the diagnosis of death caused by drug anaphylactic shock, and are more suitable in forensic practice.

Key words: forensic pathology, anaphylaxis, immunoglobulin E, tryptase, chymase

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