冠心病猝死心肌纤维连接蛋白免疫组化染色观察

The application of fibronectin immunohischemical staining to identifing sudden cornary death

目的研究纤维连接蛋白(FN)免疫组化染色对冠心病猝死(SCD)的病理学诊断价值。方法用兔抗人FN多克隆抗体对人SCD心肌、颅脑损伤和病毒性心肌炎致死者心肌进行FN-SP免疫组化染色观察,用图像分析处理系统对FN免疫组织化学染色阳性反应产物面积定量,所得数据进行统计分析。结果SCD组16例心肌组织内FN大量沉积;颅脑损伤致死组心肌细胞内FN染色阴性,病毒性心肌炎致死组部分心肌细胞内FN阳性;3组心肌细胞内的阳性反应面积存在显著性差异(P<0.05)。冠心病猝死组阳性反应面积(μm2)为54143.28±8474.92;颅脑损伤致组阳性反应面积(μm2)为527.99±105.04;病毒性心肌炎组阳性反应面积(μm2)为5483.53±1219.91。结论冠心病猝死者心肌FN免疫组化检测可为死因诊断提供可靠依据。

Objective To study the applicability of fibronectin （FN） to diagnosing sudden coronary death（SCD） by immunohistochemical staining. Methods The myocardial samples collected from cases died from SCD were studied using immunohistochemical SP staining with anti-fibronectin antibody. Computerized image analysis was employed to measure the FN-positive areas of myocardium, and the data was statistically analyzed. Results Dense FN deposition was found in the myocardial samples from 16 cases died of SCD, whereas negative FN immunoreactivity was observed in the cases died of head injuries, but slight FN- positive cardiomyocytes in cases died of viral myocardiatis. There were significant differences of FN positive areas in the myocardial samples among the three groups （P 〈 0, 05 ）. The positive reaction areas in the myocardium from 16 cases died of SCD were 54143.28 ±8474. 92 in average ; in the myocardium of head injuries were 527.99 ± 105.04, and in the myocardium died of viral myocardiatis were 5483.53± 1219.91. Conclusion Immunohistochemical detection of FN in myocardium is an effective approach to the postmortem diagnosis of SCD.