The Effectiveness and Limitations of Triphenyltetrazolium Chloride to Detect Acute Myocardial Infarction at Forensic Autopsy
The Effectiveness and Limitations of Triphenyltetrazolium Chloride to Detect Acute Myocardial Infarction at Forensic Autopsy
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DOI：
10.1097/paf.0b013e31828879cd
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发表时间：
2013-09-01
影响因子：
1
通讯作者：
Tamaki, Keiji
中科院分区：
文献类型：
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作者：
Kakimoto, Yu;Tsuruyama, Tatsuaki;Tamaki, Keiji
氯化三苯基四氮唑（TTC）是动物实验中检测心肌梗死面积最常用的染色剂之一。然而，其可用性和局限性尚未在法医领域得到充分讨论。在这里，作者在收获后不久用TTC染色人类心脏。使用图像分析软件分析样品的照片，该软件评价每个切片表面上染色区域的占据率。结果表明，死亡时间（PMI）越长，TTC的活性越低。死亡后1.5天内TTC染色反应良好，死亡后1.5天内TTC染色反应与PMI呈负相关（y =-0.294In（x）+1.0441; x = PMI，y = TTC染色面积/心肌总面积，R-2 = 0.5673）。陈旧性心肌梗死的样本产生清晰的TTC对比;正常组织为鲜红色，纤维化心肌为白色变色。然而，在急性心肌梗死病例中，在发病后9小时内发生死亡，即使PMI小于1.5天，也很难检测到梗死区域。总之，TTC法在死亡后1.5天内可能是有用的，但死亡前的短痛苦期干扰了其染色效率。
Triphenyltetrazolium chloride (TTC) is one of the most conventional stains to detect infarcted area of the heart in animal experiments. However, its availability and limitations have not been thoroughly discussed in the forensic field. Here, authors stained human hearts with TTC soon after the harvest. Photographs of the samples were analyzed using image analysis software, which evaluated the occupying ratio of the stained area on the surface of each slice. The results showed that the stainability of TTC declines with the length of the postmortem interval (PMI). Specimens reacted well to TTC within 1.5 days after death and then decreased the stainability logarithmically with PMI (y = -0.294 In (x) + 1.0441; x = PMI, y = TTC-stained area / total myocardial area, R-2 = 0.5673). Samples with old myocardial infarction produced clear TTC contrast; normal tissue is vivid red, and fibrotic myocardium is white discoloration. In acute myocardial infarction cases where death occurred within 9 hours after the attack, however, the detection of infarcted area was very difficult even when PMI was less than 1.5 days. In summary, the TTC method may be useful within 1.5 days after death, but short suffering period before death disturbs its staining efficiency.