| 黄万麒 林宴 余蒙 李利华 曾晓锋.30 例病毒性心肌炎法医病理学分析[J].,2015,15(31):6160-6162 |
| 30 例病毒性心肌炎法医病理学分析 |
| Forensic Pathology Analysis of 30 Cases of Viral Myocarditis |
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| DOI： |
| 中文关键词: 病毒性心肌炎 法医病理学 法医学鉴定 |
| 英文关键词: Viral myocarditis Forensic pathology Forensic identification |
| 基金项目:云南省科技厅-昆明医科大学联合专项（2013FB127）；云南省教育厅重点项目（2012Z086） |
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| 中文摘要: |
| 目的：回顾性分析30 例病毒性心肌炎的法医病理学特点，为病毒性心肌炎的法医学鉴定提供依据。方法：采用昆明医科大
学司法鉴定中心2003 年至2014 年的30例病毒性心肌炎法医病理鉴定案例进行回顾性分析。结果：30 例死亡原因均为病毒性心
肌炎致急性心功能障碍死亡，大多为重型病毒性心肌炎，均累及心肌损害，心肌细胞水肿，基质溶解坏死；心肌肌间多量淋巴细胞
浸润；局部心肌束排列紊乱，间质纤维组织增生，同时不同程度伴有肺、脑、扁桃体等器官组织的损害。结论：重型病毒性心肌炎起
病急，临床症状不典型，进程快，易造成误诊误治，死亡率高，产生医疗纠纷，需要法医学鉴定。病毒性心肌炎法医学鉴定时，以心
脏大体所见和组织学观察为主要依据，同时还要特别注意其他机械性损伤，辨别每个死亡原因之间的关系，必要时结合特殊检
查，例如对趋化因子MCP-1 的检测。 |
| 英文摘要: |
| Objective:Through the retrospective of the forensic assessment cases of 30 Cases of viral myocarditis, to provide reference
for the forensic assessment in those cases.Methods:30 cases of viral myocarditis's death from the judicial identification center of
Kunming Medical University between January 2003 to July 2014 were retrospected.Results:Most of the 30 cases died of acute cardiac
dysfuction due to heavy viral myocarditis and all cause myocardial damage.Myocardial damage mainly includes cardiocyte edema, matrix
dissolute and necrosis,many lymphocytes are scattered in the myocardial interstitium, at the same time accompany with different level
damage of organs such as lung, brain, amygdala.Conclusion:Severe viral myocarditis is repid onset and atypical clinical symptoms, fast
process, incur misdignose and therapeutic error easily, high mortality, so foresic identification is needed. When identificating viral myocarditis
in forensic, heart generally and microscopic observed as the main base, but also paying special attention to other mechanical damage,
identifing of the relationship between each causes of death, combining with the special inspection when necessary, for example the
detection of chemokines MCP - 1. |
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