非创伤性脂肪栓塞研究现状及法医学应用展望  

Research Status and Prospects of Non-Traumatic Fat Embolism in Forensic Medicine

作　　者：张梦真 孟运乐 凌浩森 黄申 缪麒 张燕琳 杨兴安 李冬日 ZHANG Meng-zhen;MENG Yun-le;LING Hao-sen;HUANG Shen;MIAO Qi;ZHANG Yan-lin;YANG Xing-an;LI Dong-ri(The First Clinical Medical College,Southern Medical University,Guangzhou 510515,China;School of Forensic Medicine,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学第一临床医学院,广东广州510515 [2]南方医科大学法医学院,广东广州510515

出　　处：《法医学杂志》2022年第2期263-266,279,共5页Journal of Forensic Medicine

基　　金：大学生创新创业训练计划资助项目(S201912121103)。

摘　　要：在法医病理学实践中,脂肪栓塞是较常见的死亡原因之一,可分为创伤性和非创伤性两类。非创伤性脂肪栓塞指基础疾病、应激、中毒、脂质代谢障碍等非创伤性因素导致的循环血流中出现脂滴阻塞小血管。目前认为,非创伤性脂肪栓子的产生与脂质代谢障碍、C反应蛋白相关级联反应、乳糜微粒和极低密度脂蛋白凝集有关。非创伤性脂肪栓塞的法医学死因鉴定主要依据案情、系统尸体解剖、HE染色和脂肪染色,但由于其危险因素不明、发病隐匿、HE染色不易察见、脂肪染色未常规化实施,易被鉴定人漏诊或误诊。针对目前法医学鉴定中对非创伤性脂肪栓塞重视不足的问题,本文就非创伤性脂肪栓塞相关概念、病理生理学机制、研究进展、现存问题及对策等进行综述,供法医学者借鉴和参考。In the practice of forensic pathology,fat embolism is one of the common causes of death,which can be divided into two categories:traumatic and non-traumatic.Non-traumatic fat embolism refers to the blockage of small blood vessels by fat droplets in the circulatory blood flow caused by non-traumatic factors such as underlying diseases,stress,poisoning and lipid metabolism disorders.At present,it is believed that the production of non-traumatic fat embolism is related to the disturbance of lipid metabolism,C-reactive protein-related cascade reaction,the agglutination of chylomicron and very low-density lipoprotein.The forensic identification of the cause of death of non-traumatic fat embolism is mainly based on the case,systematic autopsy,HE staining and fat staining,but it is often missed or misdiagnosed by forensic examiners because of its unknown risk factors,hidden onset,the difficulty of HE staining observation and irregular implementation of fat staining.In view of the lack of attention to non-traumatic fat embolism in forensic identification,this paper reviews the concepts,pathophysiological mechanism,research progress,existing problems and countermeasures of nontraumatic fat embolism,providing reference for forensic scholars.

关 键 词：法医病理学 非创伤性脂肪栓塞 病理生理机制 综述 

分 类 号：DF795.1[医药卫生—法医学]