本文關鍵詞： 法醫(yī)學 心肌損傷標志物 死亡時間　出處：《重慶醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:通過對不同死因(溺死、以心肌損傷為主)大鼠死后不同時間心肌損傷標志物含量變化進行研究,分析不同死因大鼠死亡后心肌損傷標志物的變化規(guī)律,完善心肌損傷標志物在死后檢測的法醫(yī)學意義。方法:選取SD大鼠75只,體重為275g±25克,隨機分為3組(n=25):胸部打擊組采用改進BIM-II型生物撞擊機閉合式打擊大鼠心前區(qū),打擊力度為120Kpa;溺死組;空白對照組脫頸處死。各組大鼠各分為五個亞組(n=5),分別于死亡后6h、12h、24h、48h、72h取右心血液并制備成血清,對心肌酶譜五項及肌鈣蛋白進行檢測,同時提取心肌組織進行HE染色;計量資料以均數±標準差表示,采用單因素方差分析,對比三組之間差別,p0.05時,其差異具有統(tǒng)計學意義;對每組死亡后經歷時間與心肌損傷標志物進行線性回歸,R2≥0.8認為心肌損傷標記物與時間之間具有線性關系。結果:(1)采用BIM-II型生物撞擊機閉合式打擊大鼠心前區(qū)建立SD大鼠心臟挫傷模型成功。(2)除48小時的CK,6小時的LDH,72小時的GPT外,對照組和溺死組心肌損傷標志物之間的差異無統(tǒng)計學意義(P0.05);CK-MB三組兩兩之間無統(tǒng)計學意義(P0.05),c Tn T、CK、GOT、LDH幾項指標在打擊組與空白組,打擊組與溺死組之間大部分時間點上,其差異無統(tǒng)計學意義(P0.05);GPT上,打擊組和空白組,打擊組和溺死組大部分時間點上差異具有統(tǒng)計學意義(P0.05)。對同一死因不同時間點的組內對比發(fā)現,三組大鼠死后6h和其他時間點大部分差異具有統(tǒng)計學意義(P0.05),其他時間點上大部分心肌損傷標志物之間的差異無統(tǒng)計學意義(P0.05)。(3)空白對照組大鼠各項心肌損傷標志物中,c Tn T,LDH的含量與時間呈線性關系(R20.8);胸部打擊組中,c Tn T,CK-MB的含量與時間呈線性關系(R20.8);溺死組中,LDH的含量與時間呈線性關系(R20.8);其余指標在各組中,含量和時間均不呈線性關系。在呈線性關系的心肌損傷標志物中,空白對照組c Tn T在含量是隨著死亡時間的增加而降低的(呈負相關),而在胸部打擊組中c Tn T的含量卻隨著死亡時間的增加而增加(正相關)。結論:(1)采用BIM-II型生物撞擊機閉合式打擊大鼠心前區(qū)建立SD大鼠心臟挫傷模型是成功的,可用于心肌挫傷的系列研究。(2)文中涉及的三種死因死亡的尸體,在20℃、濕度78%條件下保存,3天內細胞結構仍可辨認,可用于形態(tài)學診斷。(3)心肌損傷標志物在死亡后12-72小時內無統(tǒng)計學差異,故心肌損傷標志物在死亡后3天內可以作為心肌損傷的輔助診斷指標之一。(4)不同死因死亡的SD大鼠血清心肌損傷標志物隨死后經歷時間變化呈現不同趨勢,通過血清心肌損傷標志物推斷死亡時間需考慮死因的影響。
[Abstract]:Objective: to study the changes of myocardial injury markers at different time after death in rats with different causes of death (drowning, mainly myocardial injury), and to analyze the changes of myocardial injury markers in rats with different causes of death. Methods: 75 SD rats were selected and weighed 275 g 鹵25 g. Three groups were randomly divided into three groups: the chest blow group used the improved BIM-II biological impingement machine to strike the precardiac area of the rat, and the striking force was 120kpa. Drowning group; The rats in each group were divided into five subgroups. The right heart blood was collected at 12 hours, 24 hours and 48 hours after death, and the serum was prepared. Five items of myocardial enzyme spectrum and cardiac troponin were detected, and myocardial tissues were extracted for HE staining. The measurement data were expressed as mean 鹵standard deviation, and the difference between the three groups was statistically significant when single factor analysis of variance was used to compare the difference between the three groups (p0.05). Linear regression was performed between postmortem duration and myocardial injury markers in each group. R2 鈮，

本文編號：1453714