
纤维肌性发育不良的研究现状及法医学意义
谢嘉珑, 杜宇, 胡圣祥, 欣舟锐, 刘亚楠
纤维肌性发育不良的研究现状及法医学意义
Current research status and forensic significance of fibromuscular dysplasia
纤维肌性发育不良(fibromuscular dysplasia,FMD)是累及全身中小动脉的原发性、节段性、非动脉粥样硬化性、非炎症性动脉壁肌层疾病,以女性多见。FMD的病因及发病机制仍未完全明确,目前多认为可能是遗传(基因变异)和环境因素(激素、炎症以及血管机械刺激等)共同作用的结果。FMD分为内膜型、中膜型、外膜型及混合型。中膜型FMD最常见,占80%~90%,主要表现为动脉壁中膜平滑肌细胞发生成纤维细胞样转化,细胞和细胞外基质增生并排列紊乱,致使动脉扭曲、管壁厚薄不均,管腔不同程度狭窄。FMD累及冠状动脉、颅颈动脉可引发心源性猝死或颅内缺血性、出血性病变。本文综述FMD的研究进展,以期提高法医工作者对FMD的认识,为法医学精准死亡原因推断提供参考依据。
Fibromuscular dysplasia(FMD) is an idiopathic,segmental,non‑atherosclerotic,and non-inflammatory vascular disease that affects small‑ to medium‑sized arteries in the whole body,and it is more common in middle-aged women. The etiology and pathogenesis of FMD remain unclear,and it is currently believed that it may be the result of the combined effect of factors such as inheritance,changes in the levels of hormones/metabolism/immunity,and vascular mechanical stimulation. The main pathological features of FMD include the transformation of smooth muscle cells in the arterial wall into fibroblasts and hyperplasia and disordered arrangement of cells and extracellular matrix,resulting in arterial distortion,uneven wall thickness,and varying degrees of stenosis of the lumen. The involvement of coronary arteries and cranial and carotid arteries in FMD can cause sudden cardiac death or intracranial ischemic/hemorrhagic lesions. This article reviews the current research advances in FMD,in order to improve the understanding of FMD among domestic legal medical experts and provide a reference for accurate inference of cause of death in forensic science.
纤维肌性发育不良 / 猝死 / 死亡原因 / 法医病理学 / 综述
fibromuscular dysplasia / sudden death / cause of death / forensic pathology / review
R473.72
1 |
|
2 |
|
3 |
|
4 |
|
5 |
|
6 |
|
7 |
|
8 |
|
9 |
|
10 |
|
11 |
|
12 |
|
13 |
|
14 |
|
15 |
|
16 |
中国医疗保健国际交流促进会难治性高血压与周围动脉病分会共识起草组. 肾动脉纤维肌性发育不良诊断及处理中国专家共识[J]. 中国循环杂志,2023,38(2):131-140.
Consensus drafting group of the Difficult to Treat Hypertension and Peripheral Arterial Disease Branch of the China Association for the Promotion of International Exchange in Healthcare. Chinese expert consensus on the diagnosis and treatment of renal artery fibromuscular dysplasia[J]. Chin Circ J,2023,38(2):131-140.
|
17 |
|
18 |
蒋雄京,何际宁,陈 阳,等. 纤维肌性发育不良诊断及处理的首个国际共识评释[J]. 中国循环杂志,2019,34(S1):54-57.
|
19 |
杜万良. 纤维肌发育不良[J]. 中国卒中杂志,2007,2(6):537-541.
|
20 |
|
21 |
|
22 |
|
23 |
|
24 |
|
25 |
|
26 |
陈乃清,肖慧捷,王 芳. 儿童肾动脉纤维肌发育不良致难治性高血压1例报告[J]. 临床儿科杂志,2019,37(1):51-54.
|
27 |
|
28 |
|
29 |
|
30 |
张 甜,陈 霓,郑智勇,等. 脾动脉纤维肌肉发育不良1例并文献复习[J]. 临床与实验病理学杂志,2011,27(6):661-662.
|
31 |
|
32 |
|
33 |
|
34 |
蒋雄京,杨 倩. 纤维肌性发育不良[J]. 中华高血压杂志,2009,17(10):876-879.
|
35 |
|
36 |
|
37 |
|
38 |
黄震华. 纤维肌性发育不良引起的冠状动脉病变[J]. 中国新药与临床杂志,2016,35(3):178-181.
|
39 |
|
40 |
|
41 |
|
/
〈 |
|
〉 |