Randall B, Butts J, Halsey J F
University of South Dakota School of Medicine, Department of Laboratory Medicine, Sioux Falls, USA.
J Forensic Sci. 1995 Mar;40(2):208-11.
Elevations in tryptase, a recently discovered mast cell enzyme, have been proposed as a postmortem indicator of fatal anaphylaxis. The previous studies had limited numbers of controls and thus the specificity of the test with postmortem samples was not known. Therefore, tryptase was evaluated in postmortem blood samples from 49 autopsy cases where there was no evidence of fatal anaphylaxis. The tryptase was above the normal serum threshold of 1 nanogram/mL (ng/mL) in 31 of these cases. Twenty-four cases had values in the 1 to 5 ng/mL range, two cases were between 5 and 10 ng/mL, and five were greater than 10 ng/mL. One autopsy specimen had a tryptase value of 106 ng/mL. The postmortem interval and the specimen storage condition did not appear to correlate with these elevations in tryptase. Although elevations in the postmortem tryptase remain an important supporting finding in the diagnosis of fatal anaphylaxis, it should not be used alone as the sole criterion for the postmortem diagnosis of anaphylaxis.
类胰蛋白酶是一种最近发现的肥大细胞酶，其水平升高已被提议作为致命性过敏反应的死后指标。先前的研究对照数量有限，因此该检测对死后样本的特异性尚不清楚。因此，对49例尸检病例的死后血样进行了类胰蛋白酶评估，这些病例均无致命性过敏反应的证据。其中31例病例的类胰蛋白酶高于正常血清阈值1纳克/毫升（ng/mL）。24例病例的值在1至5 ng/mL范围内，2例在5至10 ng/mL之间，5例大于10 ng/mL。一份尸检标本的类胰蛋白酶值为106 ng/mL。死后间隔时间和标本储存条件似乎与这些类胰蛋白酶升高无关。尽管死后类胰蛋白酶升高在致命性过敏反应的诊断中仍然是一项重要的支持性发现，但它不应单独用作过敏反应死后诊断的唯一标准。
