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肾肾小球变化在淡水溺水尸体解剖诊断中的诊断价值

The Diagnostic Value of the Changes in the Renal Glomerulus in the Postmortem Diagnosis of Freshwater Drownings.

作者信息

Demirci Tuba, Sener Mustafa Talip, Sahpaz Ahmet, Sener Ebru, Kok Ahmet Nezih

机构信息

From the Department of Histology and Embryology.

Department of Forensic Medicine, Faculty of Medicine, Ataturk University.

出版信息

Am J Forensic Med Pathol. 2020 Jun;41(2):104-109. doi: 10.1097/PAF.0000000000000546.

Abstract

Drowning is one of the major causes of unintentional injury death worldwide. As there are no pathomorphological findings specific to the diagnosis of drowning, definitive postmortem diagnosis of drowning continues to be a significant problem in forensic medicine. This study aims to present an additional diagnostic sign in cases of freshwater drowning by investigating the histopathological changes of renal tissue in the postmortem diagnosis of freshwater drowning. For this purpose, 103 cases were investigated in which the causes of death were freshwater drowning (n = 45), traffic accidents (n = 33) and acute myocardial infarction (n = 25). Renal corpuscular structures of selected cases were examined stereologically and histopathologically. Renal corpuscle diameter, renal corpuscle surface area, glomerular tuft surface area, and Bowman space were calculated by stereological method. When compared with the glomeruli of the control group, renal corpuscle diameter, renal corpuscle surface area, glomerular tuft surface area, and Bowman space values of kidney tissues of all freshwater drowning cases were found to be decreased (P < 0.001). These changes may be considered as an essential histopathological finding in postmortem diagnosis of freshwater drowning cases.

摘要

溺水是全球意外伤害死亡的主要原因之一。由于没有特定于溺水诊断的病理形态学发现,溺水的明确死后诊断仍然是法医学中的一个重大问题。本研究旨在通过调查淡水溺水死后诊断中肾组织的组织病理学变化,提出淡水溺水病例中的一种额外诊断标志。为此,对103例死亡原因分别为淡水溺水(n = 45)、交通事故(n = 33)和急性心肌梗死(n = 25)的病例进行了调查。对所选病例的肾小体结构进行了体视学和组织病理学检查。通过体视学方法计算肾小体直径、肾小体表面积、肾小球丛表面积和鲍曼间隙。与对照组的肾小球相比,所有淡水溺水病例肾组织的肾小体直径、肾小体表面积、肾小球丛表面积和鲍曼间隙值均降低(P < 0.001)。这些变化可被视为淡水溺水病例死后诊断中的一项重要组织病理学发现。

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