Bajanowski T, Wiegand P, Cecchi R, Pring-Akerblom P, Adrian T, Jorch G, Brinkmann B
Institut für Rechtsmedizin, Westfälische Wilhelms-Universität, Münster, Germany.
Virchows Arch. 1996 May;428(2):113-8. doi: 10.1007/BF00193939.
Respiratory tract infections have been thought to act as a trigger mechanism in sudden infant death. In 118 autopsy cases of infant death, paraffin-embedded or frozen lung tissues were investigated by means of a nested polymerase chain reaction (PCR) to detect adenovirus (AV) DNA. The primers used are general primers and allow the detection of most pathogenic adenoviruses with high specificity and sensitivity and independently of devitalization of viruses or degradation of viral DNA. For the investigation three groups were established: there were 13 cases of unnatural death, 78 cases of natural death without histological signs of interstitial pneumonia, and 27 cases with interstitial pneumonia. The first group was AV negative. In the group without interstitial pneumonia AV was detected in 10.2% of the cases. In the group with interstitial pneumonia the frequency of AV detection was almost 26%. The results obtained demonstrate an association between interstitial pneumonia and detection of AV DNA, indicating that AV may play an important part in pulmonary infection in infants. Histological evidence of interstitial pneumonia was not observed in all AV-positive cases, perhaps because nonspecific virus-related changes occurred only in early stages of viral infection. Comparison of the AV frequency in SIDS (25%) and non-SIDS cases (4%) indicates an association between pulmonary AV infections and sudden death. These results support the working hypothesis of respiratory infections acting as a trigger mechanism in sudden infant death.
呼吸道感染一直被认为是婴儿猝死的触发机制。在118例婴儿死亡尸检病例中，采用巢式聚合酶链反应（PCR）对石蜡包埋或冷冻的肺组织进行检测，以检测腺病毒（AV）DNA。所用引物为通用引物，能够以高特异性和敏感性检测大多数致病性腺病毒，且不受病毒失活或病毒DNA降解的影响。为进行此项研究，设立了三组：13例非自然死亡病例，78例无间质性肺炎组织学征象的自然死亡病例，以及27例间质性肺炎病例。第一组腺病毒检测呈阴性。在无间质性肺炎的组中，10.2%的病例检测到腺病毒。在间质性肺炎组中，腺病毒检测频率近26%。所获结果表明间质性肺炎与腺病毒DNA检测之间存在关联，提示腺病毒可能在婴儿肺部感染中起重要作用。并非所有腺病毒阳性病例均观察到间质性肺炎的组织学证据，这可能是因为非特异性病毒相关改变仅发生在病毒感染的早期阶段。婴儿猝死综合征（SIDS）病例（25%）和非SIDS病例（4%）中腺病毒频率的比较表明肺部腺病毒感染与猝死之间存在关联。这些结果支持呼吸道感染作为婴儿猝死触发机制的工作假说。
