窦房结动脉狭窄与窦房结脂肪、纤维增多、凋亡及猝死的关系

发布时间：2019-04-13 12:20

【摘要】：目的：探讨窦房结动脉狭窄和窦房结内纤维含量、脂肪含量的关系，明确窦房结动脉狭窄与猝死的关系，，为窦房结内病理性纤维化或脂肪浸润的发病机理及传导系统病变的猝死机理提供理论基础。揭示窦房结病理改变引起猝死的法医病理学特征。研究背景：多个案例报道心脏传导系统动脉管壁增厚、管腔狭窄引起猝死，伴或不伴有窦房结内间质含量增多。一项系统性研究揭示房室结动脉病变在心源性猝死组的狭窄程度明显高于年龄匹配的外伤死亡组，提示传导系统动脉病变可能是猝死的原因之一。目前未见窦房结动脉病变和猝死关系的系统研究。方法：通过回顾性研究将符合纳入标准的148例临床表现为猝死或不明原因死亡者按照系统尸体解剖后确定的死亡原因分为传导系统病变猝死组(59例，平均年龄32.10±12.76岁)、心脏疾病死亡组(41例，平均年龄46.51±13.84岁)和非心脏原因死亡组(48例，平均年龄33.31±15.16岁)。石蜡包埋的心脏窦房结组织连续切片分别进行HE染色、Masson染色和弹力及胶原纤维双色染色，应用图像分析技术检测窦房结动脉内径、内外径比、纤维含量和脂肪含量，观察窦房结及心脏组织病理改变。采用国际通用的SPSS 11.5软件包中构成比、x~2检验、方差分析等统计学方法进
[Abstract]:Objective: to investigate the relationship between sinus node artery stenosis and fiber content and fat content in sinoatrial node, and to clarify the relationship between sinus node artery stenosis and sudden death. It provides a theoretical basis for the pathogenesis of pathological fibrosis or fat infiltration in sinoatrial node and the mechanism of sudden death in conduction system lesions. To reveal the forensic pathological features of sudden death caused by sinoatrial node pathological changes. Background: the thickening of arterial wall in cardiac conduction system, sudden death caused by stenosis of lumen, and the increase of interstitial content in sinoatrial node were reported in many cases. A systematic study revealed that the degree of stenosis of atrioventricular nodal artery lesions in the sudden cardiac death group was significantly higher than that in the age-matched traumatic death group, suggesting that the arterial lesion of the conduction system may be one of the causes of sudden death. At present, there is no systematic study on the relationship between sinus node artery disease and sudden death. Methods: 148 cases of sudden or unknown death were divided into sudden death group (59 cases) and sudden death group (59 cases) according to the causes of death determined after systematic autopsies. The mean age was 32.10 卤12.76 years old, 41 patients died of cardiac disease (mean age 46.51 卤13.84 years) and 48 patients died of non-cardiac causes (mean age 33.31 卤15.16 years). The paraffin embedded sections of sinoatrial node were stained with HE, Masson, elastic and collagen fibers respectively. The internal diameter, internal / external diameter ratio, fiber content and fat content of sinoatrial node artery were measured by image analysis technique. The sinoatrial node and the pathological changes of cardiac tissue were observed. The statistical methods such as composition ratio, x ~ (2) test, variance analysis and so on are adopted in the SPSS 11.5 software package, which is widely used in the world.
【学位授予单位】：四川大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：D919.1

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