Michaud Katarzyna, Romain Nathalie, Taroni Franco, Horisberger Béat, Mangin Patrice
Institut Universitaire de Médecine Légale, 1005 Lausanne, Switzerland.
Forensic Sci Int. 2002 Nov 5;130(1):13-24. doi: 10.1016/s0379-0738(02)00269-4.
A simplified method of the His bundle analysis is evaluated by the study of 110 forensic cases. The atrioventricular node or its part were observed in 96 cases (87.3%), penetrating bundle in 92 cases (83.6%), branching and left bundles branch in 109 cases (99.1%) and right bundle branch in 73 cases (66.4%). The changes such as fibrosis and fatty infiltration show statistically significant differences (P<0.01) between progressive age groups confirming their degenerative and age-related nature. The study included as well nine cases of sudden unexpected death and two cases of sudden infant death syndrome (SIDS), for which the autopsy with histological examination and toxicological analysis resulted negative. For nine of these cases, pathological lesions were found which can even explain the fatal issue. Moreover, in the cases with known cause of death, potentially lethal changes were noticed. This simple, low cost technique could be proposed to forensic pathologists as easy to fit into the routine processing of autopsy material, allowing the detection of major abnormalities with minimal effort. The authors also consider the difficulties related to the interpretation of the pathological findings in the conduction system.
通过对110例法医病例的研究，对希氏束分析的一种简化方法进行了评估。在96例（87.3%）病例中观察到房室结或其部分，在92例（83.6%）病例中观察到穿透束，在109例（99.1%）病例中观察到分支和左束支，在73例（66.4%）病例中观察到右束支。纤维化和脂肪浸润等变化在不同年龄组之间显示出统计学上的显著差异（P<0.01），证实了它们的退行性和与年龄相关的性质。该研究还包括9例意外猝死病例和2例婴儿猝死综合征（SIDS）病例，尸检结合组织学检查和毒理学分析结果均为阴性。在其中9例病例中发现了甚至可以解释致命结局的病理病变。此外，在已知死因的病例中，也注意到了潜在的致命性变化。这种简单、低成本的技术可以推荐给法医病理学家，因为它易于纳入尸检材料的常规处理流程，只需付出最小的努力就能检测到主要异常。作者还考虑了与传导系统病理结果解释相关的困难。
