Dean D E, Schultz D L, Powers R H
Franklin County Coroner's Office, Columbus, OH 43201, USA.
J Forensic Sci. 2001 Sep;46(5):1239-43.
This report describes seven deaths caused by angioedema of the tongue related to angiotensin converting enzyme (ACE) inhibitors. These seven cases were received in our office between 1998 and 2000. In that time frame we performed approximately 2000 autopsies. The cases involved African-American men and women, aged 51 to 65 years, all of whom had been prescribed an ACE inhibitor for the treatment of hypertensive heart disease. In each case, the external examination revealed markedly swollen tongues. The autopsies confirmed massive tongue swelling due to angioedema, and some patients also had swelling of the lips, pharynx, and larynx. Toxicologic analyses on postmortem blood samples were negative for ethanol and drugs of abuse. Although oral and pharyngeal swelling related to angioedema is well known in the clinical literature, its fatal potential has rarely been described.
本报告描述了7例因血管紧张素转换酶（ACE）抑制剂相关的舌血管性水肿导致的死亡病例。这7例病例于1998年至2000年期间在我们办公室接收。在该时间段内，我们进行了约2000例尸检。这些病例涉及年龄在51至65岁之间的非裔美国男性和女性，他们均被开了ACE抑制剂用于治疗高血压性心脏病。在每例病例中，外部检查均显示舌头明显肿胀。尸检证实因血管性水肿导致舌头大量肿胀，部分患者还伴有嘴唇、咽部和喉部肿胀。对死后血液样本的毒理学分析显示乙醇和滥用药物检测呈阴性。尽管血管性水肿相关的口腔和咽部肿胀在临床文献中已有记载，但其致命风险却鲜有描述。
