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Verification of our proposal of sudden infant death syndrome (SIDS) diagnosis

验证我们的婴儿猝死综合症 (SIDS) 诊断建议

基本信息

批准号：
12470109
负责人：
TAKATSU Akihiro
金额：
$ 8.58万
依托单位：
The Jikei University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2003
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12470109/
关键词：
sudden infant death syndrome sudden infant death SIDS organ weight petechial bleeding asphyxation KL-6 pulmonary infection 乳幼児突然死肺サーファクタント

项目摘要

There are many sudden unexpected infant death cases which are easily diagnosed as sudden infant death syndrome (SIDS) both with or without autopsy in Japan and a easy SIDS diagnosis may provide a cover for accidental or criminal death. Therefore we proposed criteria for a forensic pathological SIDS diagnosis, that is, SIDS should be diagnosed only on the basis of thorough autopsy, death scene investigation and complete rule out of suspicion of accidental or criminal death. The purpose of present study was to verify our criteria in the autopsy cases of sudden infant death, retrospectively and prospectively. Retrospective investigation revealed that only 14 cases of 307 forensic autopsy cases of sudden infant death, in which 122 cases were diagnosed SIDS as the cause of death, should be SIDS as the cause of death according to the criteria.. Our proposal of the criteria may contribute to the recent decrease of SIDS diagnosis in Japan with or without autopsy. As special communications we studied on analysis of autopsy findings, such as organ weight, the existence of petechial bleedings, immunohistochemical analysis of 1 50-kDa oxygen regulated protein, KL-6, pulmonary surfactant-associated protein A in the lung from sudden infant death cases and on the biochemical analysis of postmortem biochemical markers for differential diagnosis between asphyxation death and pulmonary infection death.

在日本，有许多婴儿意外猝死病例很容易被诊断为婴儿猝死综合征（SIDS），无论是否进行尸检，简单的SIDS诊断可能会为意外或刑事死亡提供掩护。因此，我们提出法医病理学诊断SIDS的标准，即只有在彻底尸检、现场勘查和完全排除意外死亡或刑事犯罪嫌疑的基础上才能诊断SIDS。本研究的目的是验证我们的标准在尸检的婴儿猝死的情况下，回顾性和前瞻性。回顾性调查发现，307例婴儿猝死法医学尸检中仅有14例符合SIDS死因标准，其中122例诊断为SIDS死因。我们的建议的标准可能有助于最近在日本的小岛屿发展中国家的诊断减少或没有尸检。作为专题交流，我们研究了尸检结果的分析，如器官重量，有无瘀斑，肺中150-kDa氧调节蛋白，KL-6，肺表面活性物质相关蛋白A的免疫组化分析，以及死后生化指标的生化分析，以鉴别窒息死亡和肺部感染死亡。