肥大细胞类胰蛋白酶的免疫组化染色观察

目的　观察过敏性休克死亡者咽喉、肺、小肠组织肥大细胞类胰蛋白酶 (MCT) ,探讨过敏性休克死亡法医鉴定的形态学依据。方法　交通事故致严重颅脑损伤死亡者 10例 (对照组 )、明确诊断为过敏性休克死亡者 15例(实验A组 )和羊水栓塞死亡者 8例 (实验B组 )的尸体 ,分别取其咽喉部、肺及小肠组织 ,石蜡切片 ,HE染色及用免疫组化超敏SP法进行MCT染色。结果　实验A组的咽喉部组织充血、水肿 ,咽喉部粘膜下层MCT增多 (MCT颗粒计数为 48 2 3 ) ;实验B组的咽喉部粘膜下层MCT增多 (MCT颗粒计数为 42 72 )。肺间质尤其是小支气管壁及小血管壁上MCT增多 (MCT颗粒计数分别为 46 98和 43 5 0 ) ,小肠粘膜层MCT增多 (MCT颗粒计数分别为 48 2 3和 42 72 )。对照组的咽喉部、肺和小肠MCT颗粒计数较少 ,分别为 7 79、 12 94和 2 0 2 5。实验A组与对照组相比 ,两组具有显著性差异 (P <0 0 1) ;实验A、B组相比 ,两组无显著性差异 (P >0 0 1)。结论　过敏性休克及羊水栓塞死亡的尸体 ,其咽喉部组织、肺组织及胃肠道组织MCT增多。

Immunohistochemical study of mast cell tryptase

Objective Carry out the mast cell tryptase (MCT) granule count in throat, lung and small intestine mast cells in persons died of anaphylactic shock.Method Control group: 10 cases died from severe brain injury. Research group:15 cases died from anaphylactic shock(group A)and 8 cases died of amniotic fluid embolism (group B). H & E staining and immunohistochemical staining were employed and the MCT granule count performed on the throat, lung and small intestine tissue.Results There was marked increase of MCT granule count in the throat (average MCT-positive number of group A 28.48 and of group B 24.35),lung (average MCT-positive number of group A 46.98 and of group B 43.50) and small intestine (average MCT-positive number of group A 48.23 and of group B 42.72) in specimens of group A and group B as compared with the control group (average number in throat 7.97,lung 12.94 and small intestine 20.25).Conclusion Tryptase granular count of MCT increased in throat, lung and small intestine tissue in persons died from anaphylactic shock and amniotic fluid embolism.