Zhu B L, Ishida K, Oritani S, Quan L, Taniguchi M, Li D R, Fujita M Q, Maeda H
Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan.
Leg Med (Tokyo). 2001 Mar;3(1):23-8. doi: 10.1016/s1344-6223(01)00006-2.
To evaluate the forensic pathological significance of the immunohistochemical distribution of pulmonary surfactant-associated protein A (SP-A) in determining the cause of death in fires, 57 fire victims were examined by scoring the staining intensity. The highest SP-A score with dense granular deposits (aggregates) in the intra-alveolar space was frequently observed in cases with a lower blood carboxyhemoglobin (COHb) level (<60%). The SP-A score was relatively low in carbon monoxide intoxication due to causes other than fires. High SP-A scores showed a relation to the serum level and in part related to the bloody exudate in the lower airway. These observations suggested that the increase in SP-A in fire victims may be mainly related to pulmonary alveolar injury due to the inhalation of hot air and/or irritant gases rather than hypoxia.
为评估肺表面活性物质相关蛋白A（SP-A）免疫组化分布在火灾死亡原因判定中的法医病理学意义，对57名火灾受害者进行检查，通过对染色强度评分。在血中碳氧血红蛋白（COHb）水平较低（<60%）的病例中，经常观察到肺泡腔内有密集颗粒状沉积物（聚集物）时SP-A评分最高。因火灾以外原因导致一氧化碳中毒时，SP-A评分相对较低。高SP-A评分与血清水平有关，部分与下呼吸道血性渗出物有关。这些观察结果表明，火灾受害者中SP-A的增加可能主要与吸入热空气和/或刺激性气体导致的肺泡损伤有关，而非缺氧。
