3种特殊染色在急性心肌梗死死后诊断中的应用比较

Application and comparison of three special stains in the postmortem diagnosis of acute myocardial infarction

目的对比观察苏木素-碱性复红-苦味酸染色(HBFP染色)、变色酸2R-亮绿染色和Heidenhain染色在急性心肌梗死死后诊断中的应用价值。方法以大鼠急性心肌梗死模型、法医检案急性心肌梗死心脏标本作为研究对象,采用HBFP染色、变色酸2R-亮绿染色和Heidenhain染色进行对比观察。结果①3种特染方法在大鼠心肌缺血15min时均可观察到阳性染色,且阳性染色面积随缺血时间的延长而扩大;②大鼠急性心肌缺血4h心脏标本在-20℃、4℃及室温条件下保存至14d,3种特染方法仍可见阳性着色,但变色酸2R-亮绿染色和HBFP染色随保存时间的延长而出现着色能力下降,阳性区域变小的趋势,Heidenhain染色效果最为稳定;③急性心肌梗死检案标本中,3种特染方法均可显示缺血心肌纤维,发病1h内死亡者Heidenhain染色优于另外两种染色。结论 3种特染均可客观的显示出急性心肌梗死早期病理改变,其中Heidenhain染色更具稳定性和可操作性。

Objective To observe comparatively the applications of HBFP stain,chrometrope 2R-Brilliant green stain and Heidenhain stain for the postmortem diagnosis of acute myocardial infarction.Methods Experimental myocardial infarction in the rat and human postmortem myocardium specimens were studied with the HBFP stain,chrometrope 2R-brilliant green stain and Heidenhain stain separately.Results ①Positive staining can be seen 15 minutes after myocardial ischemia of the rats through all three staining methods,and the positive stained areas of the heart expanded as the ischemia continued;②After the hearts,which suffered acute myocardial ischemia for 4 hours,were preserved for 14 days at-20℃,4℃ and room temperature separately,there was still positive staining in ischemic tissues with the three special stains.The coloration ability and positive stained areas of HBFP stain and chrometrope 2R-Brilliant green stain tend to decrease with the preservation time elapsed,while the Heidenhain stain is the most stable;③All three special stains can show the myocardial tissue of acute myocardial ischemia,as to cases in which the patients died within 1 hour after attack,Heidenhain stain is better than other two.Conclusion The early pathological changes of myocardial infarction can be detected by the HBFP stain,chrometrope 2R-Brilliant green stain and Heidenhain stain and Heidenhain stain is more stable and operable than the other two.