Pathological Characteristics and Classification of Unstable Coronary Atherosclerotic Plaques.

Yun-Hong Xing, Yang Li, Wen-Zheng Wang, Liang-Liang Wang, Le-le Sun, Qiu-Xiang DU, Jie Cao, Guang-Long He, Jun-Hong Sun
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Abstract

Important forensic diagnostic indicators of sudden death in coronary atherosclerotic heart disease, such as acute or chronic myocardial ischemic changes, sometimes make it difficult to locate the ischemic site due to the short death process, the lack of tissue reaction time. In some cases, the deceased died of sudden death on the first-episode, resulting in difficulty for medical examiners to make an accurate diagnosis. However, clinical studies on coronary instability plaque revealed the key role of coronary spasm and thrombosis caused by their lesions in sudden coronary death process. This paper mainly summarizes the pathological characteristics of unstable coronary plaque based on clinical medical research, including plaque rupture, plaque erosion and calcified nodules, as well as the influencing factors leading to plaque instability, and briefly describes the research progress and technique of the atherosclerotic plaques, in order to improve the study on the mechanism of sudden coronary death and improve the accuracy of the forensic diagnosis of sudden coronary death by diagnosing different pathologic states of coronary atherosclerotic plaques.

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不稳定冠状动脉粥样硬化斑块的病理特征和分类。
冠状动脉粥样硬化性心脏病猝死的重要法医诊断指标,如急性或慢性心肌缺血改变,由于死亡过程短,组织反应时间不足,有时难以确定缺血部位。有的死者在第一次发病时就猝死,导致法医难以做出准确诊断。然而,对冠状动脉不稳定斑块的临床研究发现,其病变引起的冠状动脉痉挛和血栓形成在冠心病猝死过程中起着关键作用。本文主要根据临床医学研究总结了冠状动脉不稳定斑块的病理特征,包括斑块破裂、斑块侵蚀、钙化结节等,以及导致斑块不稳定的影响因素,并简述了动脉粥样硬化斑块的研究进展和技术,以期通过对冠状动脉粥样硬化斑块不同病理状态的诊断,完善冠心病猝死机制的研究,提高冠心病猝死法医诊断的准确性。
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法医学杂志
法医学杂志 Medicine-Pathology and Forensic Medicine
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Advances in the Study of Cerebrocardiac Syndrome and Its Forensic Significance.
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