Zhu Bao-Li, Ishikawa Takaki, Michiue Tomomi, Li Dong-Ri, Zhao Dong, Quan Li, Maeda Hitoshi
Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan.
Leg Med (Tokyo). 2005 Oct;7(5):287-92. doi: 10.1016/j.legalmed.2005.04.005.
In postmortem biochemistry, there is insufficient data available for the practical analysis of factors in the pericardial fluid. The aim of the present study was to examine postmortem pericardial fluid for urea nitrogen (UN), creatinine (Cr) and uric acid (UA) levels to investigate the pathophysiology of death in forensic autopsy cases (total, n = 409; within 48 h postmortem), which included blunt, sharp instrument injury, asphyxiation, drowning, fire fatalities, hyperthermia, hypothermia, methamphetamine-related fatalities, other poisoning, delayed death from trauma and natural diseases. There was a significant elevation in the three markers for chronic renal failure, gastrointestinal bleeding, hyperthermia, hypothermia, methamphetamine fatalities and delayed traumatic death, which was comparable with the clinical criteria for their serum levels. These postmortem findings showed azotemia due to renal failure, elevated protein catabolism and rhabdomyolysis. Although the pericardial levels were otherwise similar to the clinical serum reference ranges, only the drowning fatalities showed significantly lower levels for each marker. These observations suggested the stability of UN, Cr and UA in the pericardial fluid within 48 h postmortem and their usefulness for the pathophysiological investigation of death involving azotemia.
在尸体生物化学方面，关于心包液中各因素的实际分析，可用数据不足。本研究的目的是检测法医尸检案例（共409例，死后48小时内）心包液中的尿素氮（UN）、肌酐（Cr）和尿酸（UA）水平，以研究死亡的病理生理学，这些案例包括钝器伤、锐器伤、窒息、溺水、火灾致死、体温过高、体温过低、与甲基苯丙胺相关的死亡、其他中毒、创伤后延迟死亡以及自然疾病死亡。慢性肾衰竭、胃肠道出血、体温过高、体温过低、甲基苯丙胺致死和创伤后延迟死亡的这三种标志物水平显著升高，这与它们血清水平的临床标准相当。这些尸检结果显示肾衰竭导致氮质血症、蛋白质分解代谢增加和横纹肌溶解。尽管心包液中的水平在其他方面与临床血清参考范围相似，但只有溺水致死案例的每种标志物水平显著降低。这些观察结果表明，死后48小时内心包液中UN、Cr和UA具有稳定性，且它们对涉及氮质血症的死亡病理生理学研究有用。
