Ortmann C, Pfeiffer H, Brinkmann B
Institut für Rechtsmedizin, Westfälische Wilhelms-Universität, Münster, Germany.
Int J Legal Med. 2000;113(4):215-20. doi: 10.1007/s004149900094.
The study was undertaken to evaluate the kinetics and distribution patterns of several immunohistochemical markers in ischemically and hypoxically damaged myocardium. The myocardium of 8 cases of acute myocardial infarction (AMI), 8 cases of diagnosed acute cardiac death (ACD) and 12 cases of acute exogenic hypoxia (AEH) due to CO poisoning or hanging were analysed for depletion of the cardiac antigens FABP, troponin C and T, desmin and myoglobin, loss of CD59 and deposition of the plasma antigens fibrinogen, fibronectin and the terminal complement complex C5b-9. The visualisation of the terminal complement complex was positive as early as 30 min after onset of symptoms of AMI. Depletion of cellular antigens started earlier than the deposition of plasma antigens. The deposition of fibronectin and fibrinogen began earlier than the detection of C5b-9 but later than the depletion of the cellular antigens. Our findings indicate that for the immunohistochemical detection of very early myocardial damage, the depletion of myoglobin is at least of the same rank or better than depletion of FABP and troponin.
本研究旨在评估几种免疫组化标志物在缺血和缺氧损伤心肌中的动力学及分布模式。分析了8例急性心肌梗死（AMI）、8例确诊的急性心源性死亡（ACD）以及12例因一氧化碳中毒或上吊导致的急性外源性缺氧（AEH）患者的心肌，检测心脏抗原FABP、肌钙蛋白C和T、结蛋白和肌红蛋白的耗竭情况，CD59的丢失以及血浆抗原纤维蛋白原、纤连蛋白和末端补体复合物C5b - 9的沉积情况。在AMI症状出现后30分钟，末端补体复合物的可视化即为阳性。细胞抗原的耗竭早于血浆抗原的沉积。纤连蛋白和纤维蛋白原的沉积早于C5b - 9的检测，但晚于细胞抗原的耗竭。我们的研究结果表明，对于极早期心肌损伤的免疫组化检测，肌红蛋白的耗竭至少与FABP和肌钙蛋白的耗竭具有同等或更好的效果。
