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

日本有许多婴儿猝死病例，无论有没有尸检，都很容易被诊断为婴儿猝死综合征(SID)，而简单的SID诊断可能为意外或犯罪死亡提供掩护。因此，我们提出了法医病理诊断的标准，即只有在彻底尸检、死亡现场调查和完全排除意外或刑事死亡的怀疑的基础上才能诊断出小岛屿发展中国家。本研究的目的是在婴儿猝死尸检病例中，回顾和前瞻性地验证我们的标准。回顾性调查发现，307例婴儿猝死法医尸检中仅有14例按标准诊断为小婴儿猝死，其中122例被诊断为小婴儿猝死。我们提出的标准可能有助于最近日本在尸检或不尸检的情况下对小岛屿发展中国家的诊断减少。作为专题交流，我们研究了尸检结果的分析，如器官重量、点状出血的存在，150 kDa氧调节蛋白、KL-6、肺表面活性物质相关蛋白A的免疫组织化学分析，以及鉴别窒息死亡和肺部感染死亡的死后生化标志物的生化分析。

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.