Kotabagi R B, Apte V V, Pathak P R
Reader, Department of Forensic Medicine, Armed Forces Medical College, Pune 411 040.
Professor and Head, Department of Forensic Medicine, TN Medical College and BYL Nair Hospital, Mumbai 400 008.
Med J Armed Forces India. 2000 Apr;56(2):99-102. doi: 10.1016/S0377-1237(17)30121-1. Epub 2017 Jun 10.
Acute Myocardial Infarction as a cause of death is diagnosed in many cases of sudden death based on the indirect evidence of critical narrrowing (75%) of one or more coronary arteries. Microscopic evidence of infarction is seen in H & E stained sections only if the person has survived for a minimum period of 6 hours after sustaining fatal ischaemic attack. In this study we have used two laboratory methods for visualisation of infarcts of lesser 'age', viz.-Triphenyl Tetrazolium Chloride (TTC) Macro Test and Acridine Orange Fluorescence Study. The former is a gross staining procedure which can reveal infarcts of 5-6 hours age, while the later is UV Fluorescent microscopic examination capable of detecting infarcts of 2 hours age. Although these procedures are well accepted ones, the aim of this article is to induce Forensic Pathologists to incorporate these tests in the study protocol of all sudden death cases with the aim of 'visualising' the infarct rather than basing the diagnosis on indirect evidence of critical narrowing of Coronaries.
急性心肌梗死作为死亡原因，在许多猝死病例中是根据一条或多条冠状动脉严重狭窄（75%）的间接证据来诊断的。仅当个体在遭受致命性缺血发作后存活至少6小时，梗死的微观证据才会在苏木精-伊红（H&E）染色切片中可见。在本研究中，我们使用了两种实验室方法来观察较“年轻”的梗死灶，即氯化三苯基四氮唑（TTC）大体试验和吖啶橙荧光研究。前者是一种大体染色程序，可显示5 - 6小时龄的梗死灶，而后者是紫外线荧光显微镜检查，能够检测出2小时龄的梗死灶。尽管这些程序已被广泛接受，但本文的目的是促使法医病理学家将这些检测纳入所有猝死病例的研究方案中，以便“观察到”梗死灶，而不是基于冠状动脉严重狭窄的间接证据进行诊断。
