法医学杂志

法医学杂志 ›› 2017, Vol. 33 ›› Issue (5): 482-485.DOI: 10.3969/j.issn.1004-5619.2017.05.005

所属专题： 心脏性猝死

• 专题 • 上一篇    下一篇

6例甲状腺功能亢进性心脏病猝死法医学分析

张孟周，李炳譞，赵  锐，官大威，张国华，吴  旭，朱宝利，李如波   

  1. 中国医科大学法医学院法医病理学教研室，辽宁 沈阳 110122
  • 发布日期:2017-10-25 出版日期:2017-10-28
  • 通讯作者: 赵锐，男，医学博士，博士研究生导师，主要从事法医病理学教学、科研和鉴定；E-mail：zhaorui@mail.cmu.edu.cn
  • 作者简介:张孟周（1992—），男，硕士研究生，主要从事组织损伤愈合机制研究；E-mail：mengzhouzhang1992@163.com
  • 基金资助:

    国家自然科学基金资助项目（81372943，81102156）；辽宁省高等学校杰出青年学者支持计划资助项目（LJQ2015119）

Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease

ZHANG MENG-ZHOU, LI BING-XUAN, ZHAO RUI, GUAN DA-WEI, ZHANG GUO-HUA, WU XU, ZHU BAO-LI, LI RU-BO   

  1. Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang 110122, China
  • Online:2017-10-25 Published:2017-10-28

被引次数

2

摘要： 目的 分析甲状腺功能亢进性心脏病（以下简称甲亢性心脏病）猝死案例，探讨其死亡的一般情况及法医病理学特点，为此类案件的法医病理学鉴定提供参考。 方法 收集中国医科大学法医学院2001—2016年6例甲亢性心脏病猝死案例，回顾性分析基本信息（性别与年龄）、临床表现、病史、解剖所见和组织病理学所见、生物化学检测指标、死亡原因。 结果 6例案例多具有明确的甲状腺功能亢进病史，并表现出不同程度的心血管病症状；均具有明显的死亡诱因；甲状腺病理学检验符合弥漫性毒性甲状腺肿的表现；心脏质量均增加，心腔扩张，心肌肥大，灶状坏死；死后心包液的生物化学检测可作为甲亢性心脏病猝死的辅助手段。 结论 对甲亢性心脏病猝死案例进行诊断时应参考临床病史、尸体检验、组织病理学检验、死后毒（药）物检验等结果综合判定，必要时进行死后甲状腺和心功能的生物化学检测。

关键词: 法医病理学；猝死, 心脏；甲状腺功能亢进症；血液化学分析；案例分析

Abstract: Objective To analyse the cases of sudden death due to hyperthyroid heart disease, and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases. Methods Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine, China Medical University. The general information （gender and age）, clinical manifestations, medical history, anatomical and histopathological findings, biochemical parameters and cause of death were analysed retrospectively. Results Most of the 6 patients had definite history of hyperthyroidism, and they all showed certain degrees of symptoms of cardiovascular disease; had obvious incentive factors of death; histopathological examination of thyroid conformed to the performances of diffuse toxic goiter; with increase of cardiac weight, dilatation of cardiac chambers, myocardial hypertrophy and focal necrosis; postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease. Conclusion The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy, histopathological examination, postmortem toxicology tests. The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary.

Key words: forensic pathology, death, sudden, cardiac, hyperthyroidism, blood chemical analysis, case analysis

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