扩张型心肌病猝死者心肌mmp-myocardial mmp in patients with sudden cardiac death due to dilated cardiomyopathy.docxVIP

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扩张型心肌病猝死者心肌mmp-myocardial mmp in patients with sudden cardiac death due to dilated cardiomyopathy.docx

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扩张型心肌病猝死者心肌mmp-myocardial mmp in patients with sudden cardiac death due to dilated cardiomyopathy

化学染色对DCM猝死案例的诊断具有较好的参考价值。【关键词】法医病理学；扩张型心肌病；心肌纤维化；MMP-9TheexpressionofMMP-9insuddendeathduetoDilatedCardiomyopathyCandidateSuiWeidongTutorProf.ZhuShaohuaAbstract【Background】Suddencardiacdeathplaysanimportantroleinstudyofforensicpathology.DilatedCardiomyopathy(DCM),alsoknownascongestiveheartfailure,isanimportantcauseofoccurrenceofsuddencardiacdeath,andtheageofonsetismostlybetweentheagesof20-50,whichseriouslythreatenstohumanhealth.ThemajorclinicalmanifestationaboutDCMisheartfailureofunknownreason.Withtheprogressofthediseaseitbehavesaspalpitation,fatigue,chesttightness,edema,shortnessofbreath,evendyspneaandothersymptoms.AsDCMhasnospecificityinclinicalfeatures,whichresultedinthatdifficulttodifferentiatedfromcoronaryheartdiseaseandotherheartdiseases(suchasischemiccardiomyopathy(ICM))indiagnose.PreviousstudiesdeemthatDCMisdevelopedfromviralmyocarditis[2-3],autoimmunedisordersandviralinfectionaremainpathogenisofDilatedCardiomyopathy.Inpathomorphology,DCMrepresentsasheartweightincreasedaswellasvolume,whichcanreaching500-800gorevenmore.Thediagnosticcriteriainmaleexceed350gandinfemalegreaterthan300g.Theleftandrightatriumandthetwoventricularallhavedilation,andsomeventricularwallsareslightlythickerornormal(eccentrichypertrophy),wallsoftheapexofhearthasabluntrounded,mitralandtricuspidvalvescancauseincompetencebecauseofventriculardistension,bilateralendocardiummaythickening,scarringandsoon.Inthecaseofthepracticeofforensicpathologyexamination,throughthecomprehensiveandsystemofanatomy,andruledoutthemechanicaldamage,choking,andothercausesofsuddendeath,DCMarenotrarecase,itsdiagnosismainlybasedonmorphologicalchangesoftheheart.Buttherearestillsomecases,nosignificantchangeinheartweight,itsventricularwallsareslightlythickerornormal,andmainlybehavesasatrialandventricularexpansion,duetolackofcleardiagnosticcriteria,afterexclusionofothercausesofsuddendeathcandiagnosedasDCM.Socancausedisputesaslackofconvincing,moreeasilybringquestionsthatthecauseofdeathisunknown,themechanismisunclear.Myocardi