类胰蛋白酶与过敏性休克死亡的法医学鉴定

Tryptase and fatal anaphylaxic reaction

目的探讨类胰蛋白酶与过敏性休克的关系。方法从类胰蛋白酶的生物学特性、正常人分布、检测方法及其与过敏性休克的关系,并应用ELISA方法检测三例尸体血清类胰蛋白酶的浓度,对三例过敏性休克死亡的案例作回顾性分析。结果两例血清中类胰蛋白酶的含量分别为52ng/ml和121ng/ml(高于正常值10倍以上),另一例浓度为0.73ng/ml。结论诊断过敏性休克,类胰蛋白酶含量的检测是很有意义的,但不能单凭检测结果下结论。

Objective To investigate the relationship between tryptase in serum and anaphylaxis.Methods The concentrations of tryptase in the sera of heart blood in three persons died from anaphylaxis shock were detected by ELISA.The first sample was obtained from a man,aged38,died of injecting Amikacin.The second sample was obtained from a man,aged42,died of injecting Cephradine.The third sample was from a woman,aged39,died of injecting Lincomycin.All samples were stored in-20℃.Results The concentrations of tryptase in sera were52ng/ml,121ng/ml and0.73ng/ml.It was unknown why the concentration of tryptase in the third sample was normal.Conclution In fetal anaphylaxia reaction tryptase measurement is a useful indicator,but the diagnosis is not to be based on the test alone.