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婴儿猝死综合征及儿童期其他死因的死后玻璃体液化学分析

Postmortem vitreous humor chemistry in sudden infant death syndrome and in other causes of death in childhood.

作者信息

Blumenfeld T A, Mantell C H, Catherman R L, Blanc W A

出版信息

Am J Clin Pathol. 1979 Feb;71(2):219-23. doi: 10.1093/ajcp/71.2.219.

Abstract

Postmortem vitreous humor concentrations reflect antemortem serum chemical values. The authors measured the postmortem vitreous humor concentrations of Na+, K+, Cl-, Ca+2, Mg+2, urea nitrogen, creatinine, and total protein of 127 children who died from sudden infant death syndrome (SIDS) and other causes. Forty-seven children, 1 hour to 13 years old, had died of medical or surgical causes; 21 children, 7 weeks to 11 years old, had died following acute trauma; 59 children, 8 days to 1 year old, had died of SIDS. There was no significant difference between mean postmortem vitreous humor concentrations of those who died of medical and surgical causes and those who died after acute trauma (non-SIDS). in both groups, the mean postmortem vitreous humor concentrations of Mg+2 and Ca+2 were significantly higher in premature infants. There was direct correlation of postmortem vitreous humor concentration and postmortem interval for K+, but the variation, +/- 26 hours, was too large to be of practical importance in estimating time of death in individual cases. The three patient groups were compared and the mean postmortem vitreous humor concentrations of all eight constituents in the SIDS and non-SIDS groups were in the same ranges. In SIDS, the mean postmortem vitreous humor concentrations of Mg+2, Cl-, and urea nitrogen were significantly different from values of the non-SIDS cases, but not enough to indicate SIDS or to be informative about the etiology of SIDS. Measurement of the concentrations of postmortem vitreous humor constituents may not aid in the diagnosis of SIDS, but may aid in discovering unsuspected antemortem serum chemical abnormalities.

摘要

死后玻璃体液浓度反映生前血清化学值。作者测量了127名死于婴儿猝死综合征(SIDS)和其他原因的儿童的死后玻璃体液中Na+、K+、Cl-、Ca+2、Mg+2、尿素氮、肌酐和总蛋白的浓度。47名年龄在1小时至13岁的儿童死于内科或外科疾病;21名年龄在7周至11岁的儿童死于急性创伤;59名年龄在8天至1岁的儿童死于SIDS。死于内科和外科疾病的儿童与死于急性创伤(非SIDS)的儿童的死后玻璃体液平均浓度之间无显著差异。在两组中,早产儿的死后玻璃体液中Mg+2和Ca+2的平均浓度显著更高。K+的死后玻璃体液浓度与死后间隔时间呈直接相关,但±26小时的变化太大,在个别病例中估计死亡时间时没有实际意义。对三组患者进行了比较,SIDS组和非SIDS组所有八种成分的死后玻璃体液平均浓度在相同范围内。在SIDS中,Mg+2、Cl-和尿素氮的死后玻璃体液平均浓度与非SIDS病例的值有显著差异,但不足以表明SIDS或提供有关SIDS病因的信息。测量死后玻璃体液成分的浓度可能无助于SIDS的诊断,但可能有助于发现未被怀疑的生前血清化学异常。

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