Significance of postmortem biochemistry in determining the cause of death.
Significance of postmortem biochemistry in determining the cause of death.
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DOI：
10.1016/j.legalmed.2009.01.048
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发表时间：
2009-04-01
期刊：
影响因子：
--
通讯作者：
Michiue, Tomomi
中科院分区：
文献类型：
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作者：
Maeda, Hitoshi;Zhu, Bao-Li;Michiue, Tomomi
关于调查死亡的生化程序，有大量具有挑战性的出版物。然而，此类程序似乎并未有效地纳入日常案件工作中。由于涉及先前存在的疾病、死亡原因、并发症、生存期和死后变化、分析物的分布和定位等各种因素，尸检时的生化特征可能显示出相当大的病例差异。死后干扰也可能由多种因素引起，包括死亡时的状态、可能的超生反应、细胞恶化造成的泄漏、扩散/再分布和分析程序。因此，地形分布的分析也很重要。当考虑到这些因素时，生化程序为调查死亡原因和过程、促成因素和诱发疾病提供了有用的发现。同时，最近的研究表明，使用 RT-PCR 对组织中生物反应物 mRNA 进行死后分子生物学分析可能有助于研究死亡的病理生理学。如上所述，使用死后生物化学和分子生物学对于研究死亡过程中涉及的全身病理生理功能变化具有优势。为此，建议将病理和生化结果的综合分析作为实验室研究的一部分，包括形态学、毒理学、微生物学、生物化学和分子生物学以及诊断成像程序。这些程序可以有效地纳入风险管理背景下的“全面尸检”。这些程序的应用可能取决于法医学尸检的概念，并且通过常规案例工作建立尸检数据库至关重要。
There have been an abundance of challenging publications on biochemical procedures for investigating death. However, such procedures do not appear to have been effectively incorporated in routine casework. Biochemical profiles at autopsy may show considerable case variations due to various factors involving preexisting disorders, the cause of death, complications, the survival period, and postmortem changes, distributions and localizations of analytes. Postmortem interference may also be caused by various factors, including the status at the time of death, possible supravital reactions, leakage from cell deterioration, diffusion/redistribution, and analytical procedures. Thus, analyses of topographic distribution are also important. When these factors are taken into consideration, biochemical procedures provide useful findings for investigating the cause and process of death, contributory conditions, and predisposing disorders. Meanwhile, recent studies showed that postmortem molecular biological analyses of mRNA of biological reactants in the tissues using RT-PCR are potentially useful for investigating the pathophysiology of death. As above, the use of postmortem biochemistry and molecular biology has advantages for investigating systemic pathophysiological functional changes involved in the dying process. For this purpose, the usefulness of comprehensive analyses of pathological and biochemical findings is suggested as part of laboratory investigations, comprising morphology, toxicology, microbiology, biochemistry and molecular biology, along with diagnostic imaging procedures. These procedures can be effectively incorporated into a 'full autopsy' in the context of risk management. The application of these procedures may depend on the concept of medicolegal autopsy, and it is essential to establish postmortem databases through routine casework.