法医学杂志

法医学杂志 ›› 2015, Vol. 31 ›› Issue (3): 206-210.DOI: 10.3969/j.issn.1004-5619.2015.03.009

• 案例分析 • 上一篇    下一篇

59例过敏反应死亡案例分析

李正东1，刘宁国1，赵子琴2，沈忆文2，陈忆九1   

  1. （1. 司法部司法鉴定科学技术研究所 上海市法医学重点实验室，上海 200063； 2. 复旦大学上海医学院法医学系，上海 200032）
  • 发布日期:2015-06-25 出版日期:2015-06-28
  • 通讯作者: 沈忆文，女，博士，副教授，主要从事法医病理学、法医临床学教学、科研及司法鉴定；E-mail：shenyiwen@fudan.edu.cn 陈忆九，男，研究员，博士研究生导师，主要从事法医病理学研究；E-mail：yijiuchen@gmail.com
  • 作者简介:李正东（1985—），男，四川安岳人，硕士，主要从事法医病理学科研及鉴定工作；E-mail：lizd@ssfjd.cn

Analysis of 59 Anaphylactic Death Cases

LI ZHENG-DONG1, LIU NING-GUO1, ZHAO ZI-QIN2, SHEN YI-WEN2, CHEN YI-JIU1   

  1. （1. Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai 200063, China; 2. Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai 200032, China）
  • Online:2015-06-25 Published:2015-06-28

被引次数

1

摘要： 目的 通过对过敏反应死亡案例分析，探索过敏反应死亡法医学鉴定标准，为法医学鉴定提供依据。 方法 收集上海地区1998—2008年59例诊断为过敏反应死亡案例，对案例中死者的临床病史、过敏反应临床表现、尸体检验结果等进行分析。 结果 59例过敏反应死亡案例中有58例死于药物过敏（其中77.6%为抗生素），正规医院与非法行医各占37.3%和61.0%，过敏症状主要为呼吸困难、颜面发绀等，自接触过敏原至死亡从1 min到3 d，血清总IgE浓度50~576.92 IU/mL，临床表现和病理解剖检查结果也有明显改变。 结论 在排除其他死因基础上，综合分析案情、病史、临床表现、尸检结果，可以得出过敏反应死亡的鉴定结论。其中案情调查（包括过临床病史、过敏原接触史、临床表现）对诊断过敏反应死亡具有关键性作用。

关键词: 法医病理学, 死亡, 过敏反应

Abstract: Objective To analyze the cases of anaphylactic death cases and explore the standards of judicial expertise of anaphylactic death for providing evidence for judicial expertise. Methods Fifty-nine cases death due to allergic reaction in Shanghai were collected. And details of medical history, clinical manifestation of anaphylactic reaction and postmortem examination findings were reviewed for all cases. Results In the 59 cases, there were 58 cases died from drug allergy, including 77.6% of them were antibiotics. The rates of treating in standard hospital and illegal clinic were 37.3% and 61.0%, respectively. The allergic symptoms were dyspnea and facial cyanosis. The time from contacting allergens to death ranged from 1 min to 3 d. The concentration of total serum IgE ranged from 50 to 576.92 IU/mL. The results of clinical manifestation and pathological anatomy had obviously changes. Conclusion Based on the exclusion of all other cause of death and synthetically analysis of details of cases, medical history, clinical manifestation and anatomy, the conclusion of anaphylactic death can reached. The details of cases including clinical history, exposure to allergens, and clinical manifestation play an important role in diagnosis of anaphylactic death.

Key words: forensic pathology, death, allergic reaction

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