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[狭窄性冠状动脉硬化病例的形态学检查及其对评估死亡竞争原因的重要性(作者译)]

[Morphometrical examinations in cases of stenosing coronary sclerosis and their importance for evaluation of competing causes of death (author's transl)].

作者信息

Weiler G, Risse M

出版信息

Forensic Sci Int. 1981 Sep-Oct;18(2):131-9. doi: 10.1016/0379-0738(81)90150-x.

Abstract

Coronary sclerosis is generally supposed to be the most important factor for coronary thrombosis, myocardial infarction and coronary heart death. Stenosing coronary sclerosis may be postmortally documented by angiography and morphometry. It is possible to obtain sufficient morphological data to suggest acute cardiac insufficiency, if the maximum grade of stenoses as a functional parameter and the heart weight are regarded in addition to the quantitative results of the three main branches of the coronary arteries (lumen and intima areas). Generally the cardiac results of autopsy are used individually and subjectively for the explanation of the cause of death. The conclusiveness of these results of autopsy depends on the circumstances of death and the existence of further pathological findings. Competing causes of death may exist in the form of illnesses, injuries, alcoholic and drug effects, physical strain and emotional stress or medical provisions. The quantitative valuation of the cardiac findings with a critical limit for an acute coronary death permits a more exact interpretation of such competing causes of death. This method of examination may also reveal an unpresumed competing cause of death, for example an intoxication. This was demonstrated by four autopsy cases.

摘要

冠状动脉硬化通常被认为是导致冠状动脉血栓形成、心肌梗死和冠心病死亡的最重要因素。死后通过血管造影和形态测量法可以记录狭窄性冠状动脉硬化。如果除了冠状动脉三个主要分支(管腔和内膜面积)的定量结果外,还将狭窄的最大程度作为功能参数以及心脏重量考虑在内,就有可能获得足够的形态学数据来提示急性心功能不全。一般来说,尸检的心脏结果是单独且主观地用于解释死亡原因。这些尸检结果的确定性取决于死亡情况以及是否存在其他病理发现。死亡的竞争原因可能以疾病、损伤、酒精和药物作用、身体疲劳和情绪压力或医疗因素的形式存在。对心脏检查结果进行定量评估并设定急性冠状动脉死亡的临界值,有助于更准确地解释这些竞争的死亡原因。这种检查方法还可能揭示一个未被推测到的竞争死亡原因,例如中毒。四个尸检案例证明了这一点。

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