广泛软组织损伤肾肌红蛋白免疫组化研究  

Immunohistochemistry on Myoglobin Renal Lesions in Human Kidney after Extensively Soft Tissues Injury

作　　者：刘迎春[1] 朱有法[2] 王立新 

机构地区：[1]中央司法警官学院,河北保定071000 [2]浙江大学医学院病理和法医研究所,浙江杭州310031 [3]浙江省余杭临平地区人民检察院,浙江杭州311100

出　　处：《法医学杂志》2005年第4期241-243,共3页Journal of Forensic Medicine

摘　　要：目的探讨肌红蛋白对挤压综合征肾功能损害的病理形态学改变及法医病理学诊断价值。方法应用EnVision(两步法)免疫组化方法和LSAB免疫组化方法,对22例生前有较广泛肌肉软组织损伤的人尸体肾脏组织(损伤组)进行肌红蛋白检测,12例无上述病史的人尸体肾脏组织作对照(对照组)。结果损伤组有8例肾远曲小管及集合管管腔管型染色呈阳性或强阳性,均见于伤后36h至10d死亡者;有7例近曲小管、远曲小管和集合管上皮腔缘附近的胞浆及腔面肌红蛋白阳性或强阳性,最早见于伤后8h死亡者,伤后24h至48h死亡者最为显著;余9例未见上述改变。对照组12例上述部位均为阴性。结论肌红蛋白管型堵塞肾小管和肌红蛋白对肾小管上皮的直接损害是挤压综合征肾功能衰竭的重要病理形态学基础,两者对挤压综合征的法医病理诊断均具有重要价值。Objective To observe the pathological changes in crush syndrome caused by myoglobin. Methods By using Envision Immunohistochemical staining, myoglobin was detected in the kidney block of 34 autopsy cases, among which 22 cases with extensively injury in muscle and soft tissues before death as experiment group, and other 12 cases without the above histories as control. Results It is showed that in the experiment group, eight cases （8/22） appeared positive staining of myoglobin masses in the cavities of renal and collecting tubules, whose injury time were range from 36 hours to 10 days. While other seven cases showed positive staining in the surface of the cavities and plasm adjacent the edges of distal tubules, collecting tubules and and proximal tibules, whose injury time were early as eight hours. During injury time between 24 and 48 hours, the staining get to the most obvious. On the contrary the control group showed negative. Conclusion Myoglobin significantly lead to crush syndrome renal damage such as the direct lesions done to tubule epithelial, the firmation of myoglobin masses, and the blockage of renal tubules. Myoglobin detection in kidney may play an important role in forensic pathological diagnosis of crush svndrnme（CS）.

关 键 词：挤压综合征 肌红蛋白 免疫组化 肾 

分 类 号：R685[医药卫生—骨科学] R542.22[医药卫生—外科学]