静脉血栓形成时间推断的法医学研究进展
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摘要
静脉血栓脱落导致的肺血栓栓塞症(pulmonary thromboembolism,PTE)是法医学实践中常见的猝死原因之一。对于一些机体受创伤后因PTE死亡,或是以非血栓相关疾病收治入院期间因PTE死亡的案例,需要法医病理学工作者分析创伤或医疗行为与静脉血栓发生之间的时间顺序,进而分析其因果关系。本文总结了法医学领域有关静脉血栓形成时间推断的研究成果,并对今后的研究进行了简要展望,以期为PTE的法医学鉴定提供参考,并为后续的研究指引方向。
Pulmonary thromboembolism(PTE), which is caused by detachment of venous thrombosis,is a common cause of sudden death in forensic practice. In the cases which die of PTE after trauma or die of PTE during non-thrombosis disease hospitalization, forensic pathologists are required to analyze the time sequence between trauma or medical practice and venous thrombosis, and then analyze their causal relationship. This review summarizes the history of thrombus age estimation and recent advances in forensic medicine, and then gives a brief outlook for future research to provide reference for forensic identification of PTE and guide follow-up studies.
Pulmonary thromboembolism(PTE), which is caused by detachment of venous thrombosis,is a common cause of sudden death in forensic practice. In the cases which die of PTE after trauma or die of PTE during non-thrombosis disease hospitalization, forensic pathologists are required to analyze the time sequence between trauma or medical practice and venous thrombosis, and then analyze their causal relationship. This review summarizes the history of thrombus age estimation and recent advances in forensic medicine, and then gives a brief outlook for future research to provide reference for forensic identification of PTE and guide follow-up studies.
引文
[1]中华医学会心血管病学分会肺血管病学组,中国医师协会心血管内科医师分会.急性肺血栓栓塞症诊断治疗中国专家共识[J].中华内科杂志,2010,49(1):74-81.
[2]RO A,KAGEYAMA N,TANIFUJI T,et al.Pulmonary thromboembolism:overview and update from medicolegal aspects[J].Leg Med(Tokyo),2008,10(2):57-71.
[3]GOLDHABER S Z,BOUNAMEAUX H.Pulmonary embolism and deep vein thrombosis[J].Lancet,2012,379(9828):1835-1846.
[4]龚道银,王耀宾,张岑岑,等.肺动脉血栓栓塞猝死23例法医病理学分析[J].法医学杂志,2010,26(1):33-36.
[5]LUCENA J,RICO A,VáZQUEZ R,et al.Pulmonary embolism and sudden-unexpected death:prospective study on 2 477 forensic autopsies performed at the Institute of Legal Medicine in Seville[J].JForensic Leg Med,2009,16(4):196-201.
[6]FINESCHI V,TURILLAZZI E,NERI M,et al.Histological age determination of venous thrombosis:a neglected forensic task in fatal pulmonary thromboembolism[J].Forensic Sci Int,2009,186(1/2/3):22-28.
[7]MOBILIA F,CASALI M B,GALLIENI M,et al.Lethal pulmonary thromboembolism:an autopsybased study on a rare but legally relevant event[J].Med Sci Law,2014,54(2):78-83.
[8]孙杰,张建华,邹冬华,等.33例肺动脉血栓栓塞死亡的法医学分析[J].法医学杂志,2015,31(5):361-365.
[9]曹喆,贺书涛,朱宝利.肺动脉血栓栓塞的法医学鉴定[J].中国法医学杂志,2012,27(4):290-291,295.
[10]MARGIOTTA G,COLETTI A,SEVERINI S,et al.Medico-legal aspects of pulmonary thromboembolism[J].Adv Exp Med Biol,2017,906:407-418.
[11]WOLBERG A S,ALEMAN M M,LEIDERMANK,et al.Procoagulant activity in hemostasis and thrombosis:Virchow’s triad revisited[J].Anesth Analg,2012,114(2):275-285.
[12]ENGELMANN B,MASSBERG S.Thrombosis as an intravascular effector of innate immunity[J].Nat Rev Immunol,2013,13(1):34-45.
[13]STARK K,PHILIPPI V,STOCKHAUSEN S,et al.Disulfide HMGB1 derived from platelets coordinates venous thrombosis in mice[J].Blood,2016,128(20):2435-2449.
[14]YAU J W,TEOH H,VERMA S.Endothelial cell control of thrombosis[J].BMC Cardiovasc Disord,2015,15:130.
[15]von BRüHL M L,STARK K,STEINHART A,et al.Monocytes,neutrophils,and platelets cooperate to initiate and propagate venous thrombosis in mice in vivo[J].J Exp Med,2012,209(4):819-835.
[16]MARTINOD K,WAGNER D D.Thrombosis:tangled up in NETs[J].Blood,2014,123(18):2768-2776.
[17]WAKEFIELD T W,MYERS D D,HENKE P K.Mechanisms of venous thrombosis and resolution[J].Arterioscler Thromb Vasc Biol,2008,28(3):387-391.
[18]ALTMANN J,SHARMA S,LANG I M.Advances in our understanding of mechanisms of venous thrombus resolution[J].Expert Rev Hematol,2016,9(1):69-78.
[19]ALI T,HUMPHRIES J,BURNAND K,et al.Monocyte recruitment in venous thrombus resolution[J].J Vasc Surg,2006,43(3):601-608.
[20]董忠礼,赵学凌.单核巨噬细胞促进静脉血栓机化再通的机制及研究进展[J].昆明医科大学学报,2016,37(4):132-136.
[21]HENKE P K,WAKEFIELD T.Thrombus resolution and vein wall injury:dependence on chemokines and leukocytes[J].Thromb Res,2009,123(S4):S72-S78.
[22]M?LLER P.Studienüber embolische und autochthone Thrombose in der Arteria pulmonalis[J].Beitr path Anat,1922,71:26.
[23]IRNIGER W.Histologische Altersbestimmung von Thrombosen und Embolien[J].Virchows Arch Pathol Anat Physiol Klin Med,1963,336(3):220-237.
[24]LEU H J.Histological age determination of arterial and venous thrombi and emboli[J].Vasa,1973,2(3):265-274.
[25]SEVITT S.Organic fragmentation in pulmonary thrombo-emboli[J].J Pathol,1977,122(2):95-103.
[26]LEU A J,LEU H J.Special problems in the histologic age determination of thrombi and emboli[J].Pathologe,1989,10(2):87-92.
[27]JANSSEN W.Forensic histopathology[M].Berlin:Springer-Verlag,1984.
[28]SAUKKO P,KNIGHT B.Knight’s forensic pathology[M].3rd ed.London:Hodder Arnold,2004.
[29]EISENMENGER W,NERLICH A,GLüCK G.The significance of collagen in determining the age of a wound[J].Z Rechtsmed,1988,100(2/3):79-100.
[30]NOSAKA M,ISHIDA Y,KIMURA A,et al.Timedependent appearance of intrathrombus neutrophils and macrophages in a stasis-induced deep vein thrombosis model and its application to thrombus age determination[J].Int J Legal Med,2009,123(3):235-240.
[31]FINESCHI V,BAFUNNO V,BELLO S,et al.Fatal pulmonary thromboembolism.A retrospective autopsy study:searching for genetic thrombophilias(Factor V Leiden(G1691A)and FII(G20210A)gene variants)and dating the thrombus[J].Forensic Sci Int,2012,214(1/2/3):152-158.
[32]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of MMP-2 and MMP-9 in a stasis-induced deep vein thrombosis model and its application to thrombus age estimation[J].Int J Legal Med,2010,124(5):439-444.
[33]NOSAKA M,ISHIDA Y,KIMURA A,et al.Timedependent organic changes of intravenous thrombi in stasis-induced deep vein thrombosis model and its application to thrombus age determination[J].Forensic Sci Int,2010,195(1/2/3):143-147.
[34]NOSAKA M,ISHIDA Y,KUNINAKA Y,et al.Immunohistochemical detection of uPA,tPA,and PAI-1 in a stasis-induced deep vein thrombosis model and its application to thrombus age estimation[J].Int J Legal Med,2012,126(3):421-425.
[35]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of intrathrombotic macrophage-derived cytokines and its application to thrombus age estimation in murine deep vein thrombosis model[J].Int J Legal Med,2013,127(5):937-942.
[36]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of intrathrombotic IL-6and its application to thrombus age estimation[J].Int J Legal Med,2015,129(5):1021-1025.
[37]NOSAKA M,ISHIDA Y,KIMURA A,et al.Detection of intrathrombotic endothelial progenitor cells and its application to thrombus age estimation in a murine deep vein thrombosis model[J].Int J Legal Med,2017,131(6):1633-1638.
[38]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of intrathrombotic fibrocytes and its application to thrombus age estimation in murine deep vein thrombosis model[J].Int J Legal Med,2017,131(1):179-183.
[39]杨琛腾,左敏,王松军,等.血栓形成时间的推断[J].法医学杂志,2018,34(4):352-358.
[40]JIN Q Q,SUN J H,DU Q X,et al.Integrating microRNA and messenger RNA expression profiles in a rat model of deep vein thrombosis[J].Int J Mol Med,2017,40(4):1019-1028.
[41]MAFFEIS V,NICOLèL,RAGO C,et al.Histological criteria for age determination of fatal venous thromboembolism[J].Int J Legal Med,2018,132(3):775-780.
[42]CECCHI R,LAZZARO A,CATANESE M,et al.Fatal thromboembolism following physical restraint in a patient with schizophrenia[J].Int J Legal Med,2012,126(3):477-482.
[43]DIAZ J A,SAHA P,COOLEY B,et al.Choosing a mouse model of venous thrombosis[J].Arterioscler Thromb Vasc Biol,2019,39(3):311-318.
[44]于会永,李惟,徐宏.深静脉血栓形成评价量表在法医学伤病关系鉴定中的应用[J].法医学杂志,2018,34(3):299-301.
[2]RO A,KAGEYAMA N,TANIFUJI T,et al.Pulmonary thromboembolism:overview and update from medicolegal aspects[J].Leg Med(Tokyo),2008,10(2):57-71.
[3]GOLDHABER S Z,BOUNAMEAUX H.Pulmonary embolism and deep vein thrombosis[J].Lancet,2012,379(9828):1835-1846.
[4]龚道银,王耀宾,张岑岑,等.肺动脉血栓栓塞猝死23例法医病理学分析[J].法医学杂志,2010,26(1):33-36.
[5]LUCENA J,RICO A,VáZQUEZ R,et al.Pulmonary embolism and sudden-unexpected death:prospective study on 2 477 forensic autopsies performed at the Institute of Legal Medicine in Seville[J].JForensic Leg Med,2009,16(4):196-201.
[6]FINESCHI V,TURILLAZZI E,NERI M,et al.Histological age determination of venous thrombosis:a neglected forensic task in fatal pulmonary thromboembolism[J].Forensic Sci Int,2009,186(1/2/3):22-28.
[7]MOBILIA F,CASALI M B,GALLIENI M,et al.Lethal pulmonary thromboembolism:an autopsybased study on a rare but legally relevant event[J].Med Sci Law,2014,54(2):78-83.
[8]孙杰,张建华,邹冬华,等.33例肺动脉血栓栓塞死亡的法医学分析[J].法医学杂志,2015,31(5):361-365.
[9]曹喆,贺书涛,朱宝利.肺动脉血栓栓塞的法医学鉴定[J].中国法医学杂志,2012,27(4):290-291,295.
[10]MARGIOTTA G,COLETTI A,SEVERINI S,et al.Medico-legal aspects of pulmonary thromboembolism[J].Adv Exp Med Biol,2017,906:407-418.
[11]WOLBERG A S,ALEMAN M M,LEIDERMANK,et al.Procoagulant activity in hemostasis and thrombosis:Virchow’s triad revisited[J].Anesth Analg,2012,114(2):275-285.
[12]ENGELMANN B,MASSBERG S.Thrombosis as an intravascular effector of innate immunity[J].Nat Rev Immunol,2013,13(1):34-45.
[13]STARK K,PHILIPPI V,STOCKHAUSEN S,et al.Disulfide HMGB1 derived from platelets coordinates venous thrombosis in mice[J].Blood,2016,128(20):2435-2449.
[14]YAU J W,TEOH H,VERMA S.Endothelial cell control of thrombosis[J].BMC Cardiovasc Disord,2015,15:130.
[15]von BRüHL M L,STARK K,STEINHART A,et al.Monocytes,neutrophils,and platelets cooperate to initiate and propagate venous thrombosis in mice in vivo[J].J Exp Med,2012,209(4):819-835.
[16]MARTINOD K,WAGNER D D.Thrombosis:tangled up in NETs[J].Blood,2014,123(18):2768-2776.
[17]WAKEFIELD T W,MYERS D D,HENKE P K.Mechanisms of venous thrombosis and resolution[J].Arterioscler Thromb Vasc Biol,2008,28(3):387-391.
[18]ALTMANN J,SHARMA S,LANG I M.Advances in our understanding of mechanisms of venous thrombus resolution[J].Expert Rev Hematol,2016,9(1):69-78.
[19]ALI T,HUMPHRIES J,BURNAND K,et al.Monocyte recruitment in venous thrombus resolution[J].J Vasc Surg,2006,43(3):601-608.
[20]董忠礼,赵学凌.单核巨噬细胞促进静脉血栓机化再通的机制及研究进展[J].昆明医科大学学报,2016,37(4):132-136.
[21]HENKE P K,WAKEFIELD T.Thrombus resolution and vein wall injury:dependence on chemokines and leukocytes[J].Thromb Res,2009,123(S4):S72-S78.
[22]M?LLER P.Studienüber embolische und autochthone Thrombose in der Arteria pulmonalis[J].Beitr path Anat,1922,71:26.
[23]IRNIGER W.Histologische Altersbestimmung von Thrombosen und Embolien[J].Virchows Arch Pathol Anat Physiol Klin Med,1963,336(3):220-237.
[24]LEU H J.Histological age determination of arterial and venous thrombi and emboli[J].Vasa,1973,2(3):265-274.
[25]SEVITT S.Organic fragmentation in pulmonary thrombo-emboli[J].J Pathol,1977,122(2):95-103.
[26]LEU A J,LEU H J.Special problems in the histologic age determination of thrombi and emboli[J].Pathologe,1989,10(2):87-92.
[27]JANSSEN W.Forensic histopathology[M].Berlin:Springer-Verlag,1984.
[28]SAUKKO P,KNIGHT B.Knight’s forensic pathology[M].3rd ed.London:Hodder Arnold,2004.
[29]EISENMENGER W,NERLICH A,GLüCK G.The significance of collagen in determining the age of a wound[J].Z Rechtsmed,1988,100(2/3):79-100.
[30]NOSAKA M,ISHIDA Y,KIMURA A,et al.Timedependent appearance of intrathrombus neutrophils and macrophages in a stasis-induced deep vein thrombosis model and its application to thrombus age determination[J].Int J Legal Med,2009,123(3):235-240.
[31]FINESCHI V,BAFUNNO V,BELLO S,et al.Fatal pulmonary thromboembolism.A retrospective autopsy study:searching for genetic thrombophilias(Factor V Leiden(G1691A)and FII(G20210A)gene variants)and dating the thrombus[J].Forensic Sci Int,2012,214(1/2/3):152-158.
[32]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of MMP-2 and MMP-9 in a stasis-induced deep vein thrombosis model and its application to thrombus age estimation[J].Int J Legal Med,2010,124(5):439-444.
[33]NOSAKA M,ISHIDA Y,KIMURA A,et al.Timedependent organic changes of intravenous thrombi in stasis-induced deep vein thrombosis model and its application to thrombus age determination[J].Forensic Sci Int,2010,195(1/2/3):143-147.
[34]NOSAKA M,ISHIDA Y,KUNINAKA Y,et al.Immunohistochemical detection of uPA,tPA,and PAI-1 in a stasis-induced deep vein thrombosis model and its application to thrombus age estimation[J].Int J Legal Med,2012,126(3):421-425.
[35]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of intrathrombotic macrophage-derived cytokines and its application to thrombus age estimation in murine deep vein thrombosis model[J].Int J Legal Med,2013,127(5):937-942.
[36]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of intrathrombotic IL-6and its application to thrombus age estimation[J].Int J Legal Med,2015,129(5):1021-1025.
[37]NOSAKA M,ISHIDA Y,KIMURA A,et al.Detection of intrathrombotic endothelial progenitor cells and its application to thrombus age estimation in a murine deep vein thrombosis model[J].Int J Legal Med,2017,131(6):1633-1638.
[38]NOSAKA M,ISHIDA Y,KIMURA A,et al.Immunohistochemical detection of intrathrombotic fibrocytes and its application to thrombus age estimation in murine deep vein thrombosis model[J].Int J Legal Med,2017,131(1):179-183.
[39]杨琛腾,左敏,王松军,等.血栓形成时间的推断[J].法医学杂志,2018,34(4):352-358.
[40]JIN Q Q,SUN J H,DU Q X,et al.Integrating microRNA and messenger RNA expression profiles in a rat model of deep vein thrombosis[J].Int J Mol Med,2017,40(4):1019-1028.
[41]MAFFEIS V,NICOLèL,RAGO C,et al.Histological criteria for age determination of fatal venous thromboembolism[J].Int J Legal Med,2018,132(3):775-780.
[42]CECCHI R,LAZZARO A,CATANESE M,et al.Fatal thromboembolism following physical restraint in a patient with schizophrenia[J].Int J Legal Med,2012,126(3):477-482.
[43]DIAZ J A,SAHA P,COOLEY B,et al.Choosing a mouse model of venous thrombosis[J].Arterioscler Thromb Vasc Biol,2019,39(3):311-318.
[44]于会永,李惟,徐宏.深静脉血栓形成评价量表在法医学伤病关系鉴定中的应用[J].法医学杂志,2018,34(3):299-301.
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