Heidenhain法和HBFP法诊断急性早期心肌缺血的对比研究

发布时间：2018-06-14 01:09

本文选题：早期心肌缺血 + 法医病理学诊断　；参考：《昆明医学院》2006年硕士论文

【摘要】：目的：探讨铁矾苏木素伊红染色(Heidenhain stain)对诊断人体急性心肌缺血早期的可能性，最终为法医病理学死因诊断提供详实的形态学依据，为法医病理学司法鉴定提供更为适用的检测方法和较为客观的诊断指标。方法：对1995年1月-2005年12月间经昆明医学院司法鉴定中心解剖确诊为冠心病的48例人体心肌组织，应用Heidenhain染色方法检测急性心肌缺血光镜下心肌形态学改变及其与心肌缺血时间的相关规律，并将之与比较成熟的诊断早期心肌缺血的苏木素碱性复红苦味酸染色法(HBFP)及常规苏木素伊红染色法(HE)进行比较。所有数据运用SPSS11.0统计分析软件包做秩和检验。结果：1、HE染色法可以检验缺血7h之后的心肌改变；HBFP和Heidenhain染色法可以准确地检验缺血2h后的心肌改变，且心肌缺血的范围随着缺血时间的延长而逐渐增宽；Heidenhain染色缺血区域与HBFP染色缺血区域、HE染色嗜酸性增强、波状纤维、收缩带的出现区域分布相一致。2、HBFP染色和HE染色在心肌缺血2-7h对诊断心肌早期缺血的差异有统计学意义，HBFP染色优于HE染色；Heidenhain染色和HE染色在心肌缺血2-7h对诊断心肌早期缺血的差异有统计学意义，，Heidenhain染色优于HE染色；Heidenhain染色和HBFP染色在5-6h对诊断心肌早期缺血的差异有统计学意义，Heidenhain染色优于HBFP染色。结论：Heidenhain染色方法可显示早期缺血心肌纤维的相关改变，效果优于HE染色方法和HBFP染色方法，加之该法特异性强，稳定性好，价格低廉，操作简便易行，因此推荐将其作为诊断早期心肌缺血的一个首选染色方法加以推广应用。
[Abstract]:Objective: to explore the possibility of early diagnosis of acute myocardial ischemia by using hematoxylin red staining in human body, and to provide a detailed morphological basis for the diagnosis of pathophysiological causes of death. To provide a more suitable method and objective diagnostic index for forensic pathological forensic identification. Methods: from January 1995 to December 2005, 48 cases of coronary heart disease (CHD) were dissected and confirmed by the Center of Forensic expertise of Kunming Medical College. The morphological changes of acute myocardial ischemia and its correlation with myocardial ischemia time were detected by Heidenhain staining. The results were compared with that of HBFPin basic complex picric acid staining and routine hematoxylin eosin staining in the diagnosis of early myocardial ischemia. All data were tested by SPSS 11.0 statistical analysis software package. Results the myocardial changes after 7 hours of ischemia could be examined by 1: 1HE staining. HBFP and Heidenhain staining could accurately detect the myocardial changes after 2 hours of ischemia, and the extent of myocardial ischemia gradually widened with the prolongation of ischemic time. Heidenhain stained ischemic region and HBFP stained ischemic region eosinophilic and wave-like fibers were enhanced by HE staining. The distribution of systolic zone was consistent with that of HE staining and HBFP staining was better than HE staining in the diagnosis of early myocardial ischemia in 2-7 h after myocardial ischemia. There was significant difference between Heidenhain staining and HE staining in the diagnosis of early myocardial ischemia at 2-7 h after myocardial ischemia. Heidenhain staining was better than HE staining and HBFP staining in diagnosing early myocardial ischemia in 5-6 h. Heidenhain staining was better than HBFP staining in the diagnosis of early myocardial ischemia. Conclusion the ratio Heidenhain staining method is superior to the HE staining method and HBFP staining method in showing the changes of early ischemic myocardial fibers. In addition, the method has the advantages of high specificity, good stability, low price and easy to operate. Therefore, it is recommended that it be used as a preferred staining method for the diagnosis of early myocardial ischemia.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：D919

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