冠状动脉痉挛发病机制的研究进展及法医学应用  

Research Progress and Forensic Application on the Pathogenesis of Coronary Artery Spasm

作　　者：阙春杏 虞逸静 陈晗 史程 薛爱民[1,3] QUE Chun-xing;YU Yi-jing;CHEN Han;SHI Cheng;XUE Ai-min(Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China;Criminal Science and Technology Institute, Public Security of Hongkou District, Shanghai 200434, China;Shanghai Key laboratory of Crime Scene Evidence, Shanghai 200083, China)

机构地区：[1]复旦大学基础医学院法医学系,上海200032 [2]上海市公安局虹口分局刑事科学技术研究所,上海200434 [3]上海市现场物证重点实验室,上海200083

出　　处：《法医学杂志》2018年第1期60-66,共7页Journal of Forensic Medicine

基　　金：上海市现场物证重点实验室开放课题基金资助项目(2014XCWZK13);复旦大学基础医学院"正谊学者"基金资助项目(S18-14)

摘　　要：冠状动脉痉挛是指局部冠状动脉对各类刺激的过收缩反应。目前缺乏对冠状动脉痉挛导致心脏性猝死的特异性诊断指标。本文总结了目前国内外对冠状动脉痉挛发病机制的研究进展,介绍血管内皮功能障碍和血管平滑肌兴奋性增高在冠状动脉痉挛过程中的作用,并对引起血管内皮功能障碍的内源性一氧化氮、内皮素-1,与血管平滑肌兴奋性增高有关的MLC2磷酸化、Rho激酶及内质网应激的分子作用机制展开阐述,探讨相关分子在诊断冠状动脉痉挛导致心脏性猝死法医鉴定中的可能性。Coronary artery spasm(CAS)is a hyper-contraction of segmental coronary artery in response to multiple stimuli.At present,it’s still in lack of specific diagnostic indicators of sudden cardiac death caused by CAS.This review summarizes current researches on the mechanisms of CAS and describes the roles of vascular endothelial dysfunction and vascular smooth muscle hypersensitivity in the course of CAS.Furthermore,the molecular mechanisms of the endogenous NO and endothelin-1cause vascular endothelial dysfunction,and the phosphorylation of MLC2,Rho kinase and endoplasmic reticulum stress related to vascular smooth muscle hypersensitivity are discussed.Meanwhile,the possibility of forensic application for the related molecules on the diagnosis of sudden cardiac death caused by CAS are also explored.

关 键 词：法医病理学 冠状血管痉挛 综述 冠状动脉疾病 一氧化氮 内皮素-1 RHO相关激酶类 肌球蛋白轻链 

分 类 号：DF795.1[医药卫生—法医学]