Keil W, Rothämel T, Tröger H D
Institut für Rechtsmedizin, Medizinischen Hochschule Hannover.
Beitr Gerichtl Med. 1991;49:45-53.
The histological examination of cardial tissue samples concerning routine autopsy casework showed microscopic discrepancies in case of macroscopically found "subendocardial haemorrhages". In an attempt to analyse this phenomenon we compared the macroscopic and microscopic findings in 175 samples of endocardium from tissues presenting such haemorrhages of varying intensity: Only 8.6% showed a histological correlate and therefore could be verified as true haemorrhage. 53.7% presented mere hyperaemia and the remaining 37.7% even showed no microscopic finding at all. A satisfactory reason for this phenomenon could not be given by this investigation: The histological findings, however, do not depend on their cardial localization nor do they differ in relation to the cause of death or due to resuscitative actions. A possible cause of the described discrepancies may be a loss of haemoglobin of the erythrocytes. The results of this investigation point out that it might be necessary to reconsider the use of the term "subendocardial haemorrhage".
对常规尸检病例的心脏组织样本进行组织学检查发现,在宏观上发现有“心内膜下出血”的情况下,微观上存在差异。为了分析这一现象,我们比较了175份存在不同程度此类出血的组织的心内膜样本的宏观和微观发现:只有8.6%显示出组织学相关性,因此可被证实为真正的出血。53.7%仅表现为充血,其余37.7%甚至在微观上没有任何发现。本次调查未能对此现象给出令人满意的原因:然而,组织学发现并不取决于其在心脏的定位,也不因死亡原因或复苏措施而有所不同。所述差异的一个可能原因可能是红细胞血红蛋白的丢失。本次调查结果指出,可能有必要重新考虑“心内膜下出血”这一术语的使用。