부검 실무에서 사후 검체를 이용한 C-반응단백질 검사에 대한 연구
Study of the Test for Postmortem C-Reactive Protein in Routine Autopsy Practice
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
C-Reactive protein (CRP) is an acute phase response protein synthesized in the liver as a response to various inflammation. CRP is extensively used as a general marker for inflammation in clinical medicine. A forensic applications of the CRP using postmortem samples have been studied in oversea. We have compared CRP in the between antemortem and postmortem samples and studied stability of postmortem blood samples for CRP test. In 69 consecutive autopsy cases, we have analysed heart blood samples (69 cases), peripheral blood samples (33 cases), and vitreous humor samples (60 cases). Postmortem CRP was elevated in 25 cases (36.2%) and possible causes of CRP elevation were inflammatory disease except one case (unknown). Postmortem CRP test shows sensitivity 86.7%, specificity 80%, positive predictive value 92.9%, and negative predictive value 66.7% for inflammation based on 20 cases with antemortem CRP results. The postmortem CRP levels were similar in the heart blood samples and peripheral blood samples. Vitreous humor samples are not useful in postmortem CRP testing. And both whole blood and serum samples are stable in room temperature until 31 days. We conclude that serum from heart blood is best suitable sample for postmortem CRP test and postmortem CRP test is useful in routine autopsy practice to detect inflammatory disease such as sepsis. From the view of postmortem point, we desire that this valuable test should be used in routine autopsy practice in Korea.
Abstract
C-Reactive protein (CRP) is an acute phase response protein synthesized in the liver as a response to various inflammation. CRP is extensively used as a general marker for inflammation in clinical medicine. A forensic applications of the CRP using postmortem samples have been studied in oversea. We have compared CRP in the between antemortem and postmortem samples and studied stability of postmortem blood samples for CRP test. In 69 consecutive autopsy cases, we have analysed heart blood samples (69 cases), peripheral blood samples (33 cases), and vitreous humor samples (60 cases). Postmortem CRP was elevated in 25 cases (36.2%) and possible causes of CRP elevation were inflammatory disease except one case (unknown). Postmortem CRP test shows sensitivity 86.7%, specificity 80%, positive predictive value 92.9%, and negative predictive value 66.7% for inflammation based on 20 cases with antemortem CRP results. The postmortem CRP levels were similar in the heart blood samples and peripheral blood samples. Vitreous humor samples are not useful in postmortem CRP testing. And both whole blood and serum samples are stable in room temperature until 31 days. We conclude that serum from heart blood is best suitable sample for postmortem CRP test and postmortem CRP test is useful in routine autopsy practice to detect inflammatory disease such as sepsis. From the view of postmortem point, we desire that this valuable test should be used in routine autopsy practice in Korea.
참고문헌 (7)
- Astrup BS, "The routine use of C-reactive protein in forensic investigations", Forensic Sci Int, 172, pp.49~55 (2007)
- Fujita MQ, "Serum C-reactive protein levels in postmortem blood: an analysis with special reference to the cause of death and survival time", Forensic Sci Int, 130, pp.160~166 (2002)
- Tsokos M, "Interleukin-6 and C-reactive protein serum levels in sepsis-related fatalities during the early postmortem period", Forensic Sci Int, 119, pp.47~56 (2001)
- Lindroos-Jokinen K, "Postmortem measurement of C-reactive protein and interpretation of results in ketoacidosis", Leg Med (Tokyo), 14, pp.140~146 (2012)
- 나주영, "감염심내막염 부검증례 보고 및 문헌고찰", 대한법의학회지, 38(2), pp.78~82 (2014), 대한법의학회
- 나주영, "패혈증비브리오균에 의한 패혈증: 부검 증례", 대한법의학회지, 39(2), pp.45~48 (2015), 대한법의학회
- Uhlin-Hansen L, "C-reactive protein (CRP), a comparison of preand post-mortem blood levels", Forensic Sci Int, 124, pp.32~35 (2001)