| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention pertains to forensic medicine. Preliminary ischemic heart disease (IHD) is excluded as the death cause. Age, presence or absence of alcohol intoxication, amount of narrowing of coronary arteries, heart mass, degree of heart mass increase, degree of myocardial hypertrophy of the right and left ventricles of heart and are determined in the dead person. Presence or absence of microfocal and macrofocal cardiosclerosis, uneven blood filling of myocardium, dystrophic myocardial changes, focal endocardium fibrosis; amount of narrowing of the base of brain arteries is determined. Presence or absence of aorta atherosclerosis, brown induration of lungs, nutmeg liver, hepatic steatosis is detected. Microscopic signs: presence or absence of atrophy of muscular fibers, fatty infiltration of myocardium, diffuse cardiosclerosis, perivascular cardiosclerosis, microfocal and macrofocal cardiosclerosis, subendocardial cardiosclerosis, hypertrophy of muscular fibers, focal fragmentation of muscular fibers, fatty hepatosis, chronic persistent hepatitis, chronic active hepatitis, nephrosclerosis, pancreatic lipotamosis and fibrosis, excretive nephrosis are detected. Following biochemical tests results are accounted for: glucose rate in the sinuses of dura matter, glucose rate in the right ventricle, uric acid rate in the femoral vein blood, mioglobin rate in the right and left heart ventricles, creatinine rate in the femoral vein blood, glycogen rate in the myocardium of the right heart ventricle, brain-stem glycogen rates, glycogen rate in the right hemisphere of the brain, glycogen rate in cerebellum. These values are evaluated in scores according to Table 1, presented in the description; total of the scores is summed. With big number of scores in the IHD column, the latter is considered to be the cause of death, with the bigger number in the column other causes of death, or with the equal values of scores in both columns, IHD is not considered to be the potential cause of death and detection is continued. Presence or absence of focal endocardium fibrosis is assessed; microscopic signs: microfocal cardiosclerosis, subendocardial cardiosclerosis, disseminated fragmentation of muscular fibers. Biochemical test results: glucose concentration in the right and left heart clavicles; mioglobin rate in the right heart clavicle and in the pericardial fluid; glycogen rates in myocardium of the right heart clavicle, stem-brain glycogen rate, in the left hemisphere of the brain, in cerebellum; lactate dehydrogenase rates (LDG) in the myocardium of the right heart clavicle, in the myocardium of the left heart clavicle, in skeletal muscle, in the liver, in the left hemisphere of the brain, in stem-brain, in cerebellum. These rates are evaluated in scores according to Table 2, presented in the description; total of the scores is summed. With the biggest number of scores being detected in the alcohol cardiomyopathy, the latter is considered to be the cause of death; in the opposite case neither IHD nor alcohol cardiomyopathy is considered to be the cause of death. ^ EFFECT: method improves accuracy of the detection of the cause of death by accounting of positively valuable signs of the investigated pathologies: IHD and alcoholic cardiomyopathy. ^ 5 tbl, 2 ex |
