Zhu B L, Ishida K, Quan L, Fujita M Q, Maeda H
Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585, Osaka, Japan.
Forensic Sci Int. 2000 Sep 11;113(1-3):193-7. doi: 10.1016/s0379-0738(00)00264-4.
To reassess the immunohistochemical distribution of pulmonary surfactant apoprotein A (SP-A) in relation to the causes of death, 282 forensic autopsy cases were reviewed. The most intense and dense granular immunostaining of intra-alveolar SP-A was observed in the hyaline membrane syndrome from various traumas, protracted death from drowning, and perinatal aspiration of amniotic fluid. Similar granular staining pattern was found in fatal poisoning by a muscle relaxant and organophosphate pesticides. An evident increase of intra-alveolar granular staining was noted in most fatalities from mechanical asphyxia and drowning, and some cases of fire death. SP-A staining was usually very weak or sparse in alcohol intoxication, poisoning by hypnotics and also carbon monoxide poisoning. These findings suggest that the amount of intra-alveolar granular SP-A staining may be a possible indicator of severity and duration of respiratory distress (agony) from peripheral (non-central nervous system) origin and alveolar damage.
为了重新评估肺表面活性物质载脂蛋白A（SP-A）的免疫组化分布与死亡原因的关系，我们回顾了282例法医尸检病例。在各种创伤导致的透明膜综合征、溺水所致的迁延性死亡以及围产期羊水吸入病例中，观察到肺泡内SP-A的免疫染色颗粒最为强烈和密集。在肌肉松弛剂和有机磷农药中毒致死病例中也发现了类似的颗粒染色模式。在大多数机械性窒息和溺水死亡病例以及一些火灾死亡病例中，肺泡内颗粒染色明显增加。在酒精中毒、催眠药中毒以及一氧化碳中毒病例中，SP-A染色通常非常微弱或稀疏。这些发现表明，肺泡内颗粒状SP-A染色的量可能是外周（非中枢神经系统）源性呼吸窘迫（痛苦）严重程度和持续时间以及肺泡损伤的一个可能指标。
