Fieguth A, Kleemann W J, Tröger H D
Institut für Rechtsmedizin, Medizinische Hochschule Hannover, Germany.
Int J Legal Med. 1994;107(1):29-33. doi: 10.1007/BF01247271.
The distribution of the proteinase inhibitors alpha-1-antichymotrypsin (alpha 1-act), alpha-2-macroglobulin (alpha-2-m) and lysozyme was analysed immunohistochemically in 27 intravitally acquired wounds, 3 postmortem skin lacerations and 9 specimens of undamaged skin. Intravitally acquired wounds demonstrated distinct positive reactions for all antibodies examined (alpha-1-act 66.6%; alpha-2-m 51.9%; lysozyme 25.9%). However the undamaged skin margins opposite the wound margins also gave positive reactions (alpha-1-act 51.8%; alpha-2-m 37.0%; lysozyme 25.9%). Nearly half of the control cases (specimens of undamaged skin) exhibited weak positive reactions for all 3 antibodies. These could be easily distinguished from the strong positive reactions observed in intravitally acquired wounds. False positive reactions were observed due to contamination resulting from contact with serum components, in cases of advanced autolysis of specimens, and as a result of fixation and drying artefacts. Even though immunohistochemical studies of alpha-1-act, alpha-2-m and lysozyme give some indications concerning wound vitality, they cannot be considered as proof because irrefutable differentiation of true positive and false positive reactions is not possible in all cases.
采用免疫组织化学方法分析了27例活体获取的伤口、3例死后皮肤裂伤和9例未受损皮肤标本中蛋白酶抑制剂α-1-抗糜蛋白酶（α1-act）、α-2-巨球蛋白（α-2-m）和溶菌酶的分布情况。活体获取的伤口对所有检测抗体均呈现明显的阳性反应（α-1-act为66.6%；α-2-m为51.9%；溶菌酶为25.9%）。然而，伤口边缘相对的未受损皮肤边缘也呈阳性反应（α-1-act为51.8%；α-2-m为37.0%；溶菌酶为25.9%）。近一半的对照病例（未受损皮肤标本）对所有3种抗体均呈现弱阳性反应。这些弱阳性反应很容易与活体获取的伤口中观察到的强阳性反应区分开来。在标本自溶晚期，由于与血清成分接触导致污染，以及固定和干燥假象，会出现假阳性反应。尽管对α-1-act、α-2-m和溶菌酶的免疫组织化学研究为伤口活力提供了一些线索，但它们不能被视为证据，因为在所有情况下都不可能对真阳性和假阳性反应进行无可辩驳的区分。
