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[脑钠肽在心脏性猝死和非心脏性猝死心肌组织中的表达]

[Expression of Brain Natriuretic Peptide in Myocardial Tissue of Sudden Cardiac Death and Non-sudden Cardiac Death].

作者信息

Luo X Y, Xue J J, Zhang Y, Cao Z P, Tian M H, Xiao Y, Zhu B L

机构信息

School of Forensic Medicine, China Medical University, Shenyang 110122, China.

出版信息

Fa Yi Xue Za Zhi. 2017 Dec;33(6):587-591. doi: 10.3969/j.issn.1004-5619.2017.06.003. Epub 2017 Dec 25.

Abstract

OBJECTIVES

To study the expression pattern of brain natriuretic peptide (BNP) in myocardial tissue from forensic routine cases and to explore its application value in the forensic determination of sudden cardiac death (SCD).

METHODS

The data of 96 autopsy cases accepted by the center of Medico-legal Investigation of China Medical University between December 2008 to May 2014 were collected. There were 62 cases in SCD group cardiac and 34 cases in non-SCD group. The myocardial tissues were taken from left and right ventricular wall, respectively. The expressions of BNP protein and BNP mRNA in myocardial tissue were detected by HE staining, immunohistochemical staining, Western blotting and quantitative real-time reverse transcription-polymerase chain reaction (RT-qPCR), etc.

RESULTS

The immunohistochemical staining of myocardial tissue showed diffusely positive staining in SCD group, and patchily or diffusely positive staining in non-SCD group with lighter degree. The result of Western blotting showed that the expression of BNP protein elevated in left ventricular wall of SCD group. The result of RT-qPCR showed a positive correlation between the BNP mRNA expressions in bilateral ventricular walls and the heart weight, bilateral lung weight, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentration. There were large differences between the BNP mRNA concentrations in SCD group and non-SCD group, and the former was statistically higher (<0.05).

CONCLUSIONS

The expressions of BNP protein and BNP mRNA in myocardial tissue are related to the causes of death. Combined with pathological changes, the expressions of BNP protein and BNP mRNA in myocardial tissue have certainly practical significance for the determination of SCD and the analysis of the death mechanism in the cases related to forensic pathology.

摘要

目的

研究脑钠肽(BNP)在法医常规案件心肌组织中的表达模式,并探讨其在心脏性猝死(SCD)法医鉴定中的应用价值。

方法

收集中国医科大学法医学鉴定中心2008年12月至2014年5月受理的96例尸检案件资料。SCD组心脏62例,非SCD组34例。分别从左、右心室壁取材心肌组织。采用HE染色、免疫组织化学染色、蛋白质印迹法及实时定量逆转录聚合酶链反应(RT-qPCR)等方法检测心肌组织中BNP蛋白和BNP mRNA的表达。

结果

心肌组织免疫组织化学染色显示,SCD组呈弥漫性阳性染色,非SCD组呈斑片状或弥漫性阳性染色,程度较轻。蛋白质印迹法结果显示,SCD组左心室壁BNP蛋白表达升高。RT-qPCR结果显示,双侧心室壁BNP mRNA表达与心脏重量、双侧肺重量及脑钠肽N末端前体(NT-proBNP)浓度呈正相关。SCD组与非SCD组BNP mRNA浓度差异较大,前者差异有统计学意义(<0.05)。

结论

心肌组织中BNP蛋白和BNP mRNA的表达与死因有关。结合病理变化,心肌组织中BNP蛋白和BNP mRNA的表达对SCD的鉴定及法医病理学相关案件死亡机制的分析具有一定的实际意义。

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