纤维肌性发育不良的研究现状及法医学意义  

Current research status and forensic significance of fibromuscular dysplasia

作　　者：谢嘉珑 杜宇[1] 胡圣祥 欣舟锐 刘亚楠[2] Xie Jialong;Du Yu;Hu Shengxiang;Xin Zhourui;Liu Yanan(Forensic Pathology Teaching and Research Section,Department of Forensic Medicine,Criminal Investigation Police University of China;Shanghai Key Laboratory of Crime Scene Evidence,Key Laboratory of Forensic Evidence and Science Technology,Ministry of Public Security,Institute of Forensic Science,Shanghai Public Security Bureau)

机构地区：[1]中国刑事警察学院法医病理教研室,沈阳110854 [2]上海市公安局物证鉴定中心/法医物证学现场应用技术公安部重点实验室/上海市现场物证重点实验室,上海200083

出　　处：《重庆医科大学学报》2024年第12期1488-1492,共5页Journal of Chongqing Medical University

基　　金：公安部技术研究计划资助项目(编号:2022JSYJC25、2017JSYJC06、2014JSYJB13);辽宁省自然科学基金资助项目(编号:2021-MS-143);辽宁省教育厅科学研究资助项目(编号:LJKZ0081);上海市刑事科学技术研究院现场物证重点实验室开放课题资助项目(编号:2020XCWZK10);中国刑事警察学院公安学科基础理论研究创新计划资助项目(编号:2022XKGJ0106);中国刑事警察学院研究生创新能力提升资助项目(编号:2022YCZD03、2023YCZD10、2023YCYB56)。

摘　　要：纤维肌性发育不良(fibromuscular dysplasia,FMD)是累及全身中小动脉的原发性、节段性、非动脉粥样硬化性、非炎症性动脉壁肌层疾病,以女性多见。FMD的病因及发病机制仍未完全明确,目前多认为可能是遗传(基因变异)和环境因素(激素、炎症以及血管机械刺激等)共同作用的结果。FMD分为内膜型、中膜型、外膜型及混合型。中膜型FMD最常见,占80%~90%,主要表现为动脉壁中膜平滑肌细胞发生成纤维细胞样转化,细胞和细胞外基质增生并排列紊乱,致使动脉扭曲、管壁厚薄不均,管腔不同程度狭窄。FMD累及冠状动脉、颅颈动脉可引发心源性猝死或颅内缺血性、出血性病变。本文综述FMD的研究进展,以期提高法医工作者对FMD的认识,为法医学精准死亡原因推断提供参考依据。Fibromuscular dysplasia(FMD)is an idiopathic,segmental,non‐atherosclerotic,and non-inflammatory vascular disease that affects small‐to medium‐sized arteries in the whole body,and it is more common in middle-aged women.The etiology and pathogenesis of FMD remain unclear,and it is currently believed that it may be the result of the combined effect of factors such as inheritance,changes in the levels of hormones/metabolism/immunity,and vascular mechanical stimulation.The main pathological features of FMD include the transformation of smooth muscle cells in the arterial wall into fibroblasts and hyperplasia and disordered arrangement of cells and extracellular matrix,resulting in arterial distortion,uneven wall thickness,and varying degrees of stenosis of the lumen.The involvement of coronary arteries and cranial and carotid arteries in FMD can cause sudden cardiac death or intracranial ischemic/hemorrhagic lesions.This article reviews the current research advances in FMD,in order to improve the understanding of FMD among domestic legal medical experts and provide a reference for accurate inference of cause of death in forensic science.

关 键 词：纤维肌性发育不良 猝死 死亡原因 法医病理学 综述 

分 类 号：R473.72[医药卫生—护理学]