Siebert J R, Haas J E
Department of Laboratories, Children's Hospital and Medical Center, Seattle, Washington 98105.
Pediatr Pathol. 1994 Nov-Dec;14(6):973-85. doi: 10.3109/15513819409037694.
This comprehensive study of organ weights in sudden infant death syndrome (SIDS) should be of use to those studying postmortem data in SIDS and may have application to issues of growth and development. Analysis of data from 500 autopsies, performed over 15 years by one individual, revealed mean body weights generally below the 50th percentile for living infants. The weights of the thymus, lungs, liver, and brain were significantly greater than published norms. Thymic weights in SIDS probably represent the normal state more closely than those reported in several other series; elevated lung weights are presumably due to the intense pulmonary congestion and edema commonly encountered in SIDS; the liver edge routinely extends below the costal margins at SIDS autopsies, but the reason for increased weight is unknown, although a hemodynamic alteration seems likely; elevated brain weight has been described previously in SIDS. Other organs showed trends differing from "normal"--heart weights showed a marginally significant increase above published norms; for the adrenal glands, a uniform decrease was apparent, but slopes of linear regressions were low, hampering statistical analysis. Organ weights correlated more closely with body weight than with age. When victims were classified as "possible SIDS," "probable SIDS," or "classic SIDS," differences in organ weights were rarely significant. Analysis of organ weights using Z scores and their standard deviations (sigma-Z, or "pattern variability index") revealed increased variability in SIDS victims. Explanations for these findings include the possibility that some weights previously published as normal are low due to confounding variables. Changes could also be genuine, resulting from disturbances in growth or physiology, or artifactual, possibly the result of agonal or postmortem changes. A database on carefully selected, previously healthy infants who died suddenly and unexpectedly of known causes (i.e., trauma) is much needed.
这项对婴儿猝死综合征（SIDS）器官重量的全面研究，对于那些研究SIDS尸检数据的人应该会有所帮助，并且可能适用于生长发育问题。对一个人在15年期间进行的500例尸检数据的分析显示，平均体重普遍低于存活婴儿的第50百分位数。胸腺、肺、肝脏和大脑的重量明显高于已发表的标准。SIDS中的胸腺重量可能比其他几个系列报道的更接近正常状态；肺部重量升高可能是由于SIDS中常见的严重肺充血和水肿；在SIDS尸检中，肝脏边缘通常延伸至肋缘以下，但其重量增加的原因尚不清楚，尽管似乎可能存在血流动力学改变；SIDS中脑重量升高此前已有描述。其他器官显示出与“正常”不同的趋势——心脏重量略高于已发表标准，有显著增加；肾上腺则明显呈现一致下降，但线性回归斜率较低，妨碍了统计分析。器官重量与体重的相关性比与年龄的相关性更紧密。当将受害者分类为“可能的SIDS”、“很可能的SIDS”或“典型的SIDS”时，器官重量的差异很少有显著性。使用Z分数及其标准差（sigma-Z，或“模式变异性指数”）对器官重量进行分析，发现SIDS受害者的变异性增加。这些发现的解释包括，由于混杂变量，一些先前公布为正常的重量可能偏低。变化也可能是真实的，由生长或生理紊乱导致，或者是人为的，可能是濒死期或死后变化的结果。非常需要一个关于精心挑选的、先前健康但突然意外死于已知原因（即创伤）的婴儿的数据库。
