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目的探讨度冷丁药物依赖形成机制和法医学鉴定的诊断依据。方法 采用免疫组织化学SP染色法及图像分析技术,观察度冷丁慢性依赖和自然戒断大鼠大脑皮质(CC)、中脑导水管周围灰质(PAG)和中脑腹侧被盖区(VTA)神经细胞Bax的变化。结果 度冷丁慢性依赖时,大鼠表现为跳跃、竖尾等兴奋症状,自然戒断时出现高度激惹、异常姿势、叩齿、咬牙、腹泻等戒断症状和体征。对照组、慢性依赖组和自然戒断组在CC神经细胞Bax的染色灰度分别为146.0±5.92、118.6±6.77和106.0±7.49;在PAG分别为183.2±7.26、112.0±5.52和119.0±5.43;在VTA分别为171.2±9.65、113.6±4.34和93.2±6.06;BaX的表达在慢性依赖和自然戒断组比对照组明显(p<0.05);自然戒断组比慢性依赖组明显(p<0.05)。Bax阳性神经细胞数的变化趋势与Bax染色灰度结果相同。结论度冷丁药物滥用引起的神经细胞Bax明显增加可能与药物依赖的形成机制有关。Bax免疫组织化学变化可作为度冷丁吸毒法医学鉴定的形态学诊断辅助依据。
Objective To explore the diagnostic basis of the mechanism of the drug dependence and the identification of forensic medicine. Methods Immunohistochemistry (SP) staining and image analysis were used to observe the effects of chronic cold stress and chronic dementia on cerebral cortex (CC), periaqueductal gray (PAG) and mesencephalic ventral tegmental area (VTA) Changes of neuronal Bax. Results Chronic cold dependence, rats showed jumping, vertical tail and other excitement symptoms, natural abstinence when a high degree of irritation, abnormal posture, knocking teeth, teething, diarrhea and other withdrawal symptoms and signs. The staining intensity of Bax in CC nerve cells in control group, chronic dependence group and natural withdrawal group were 146.0 ± 5.92,118.6 ± 6.77 and 106.0 ± 7.49, respectively; PAG was 183.2 ± 7.26, 112.0 ± 5.52 and 119.0 ± 5.43, respectively; (P <0.05). The expression of BaX was significantly higher in chronic dependence group and natural withdrawal group than that in control group (p <0.05), while in natural withdrawal group was significantly higher than that in chronic dependence group (p <0.05) ). The trend of Bax positive neurons was the same as that of Bax staining. Conclusion The marked increase of Bax in neurons caused by the abuse of pethidine may be related to the mechanism of drug dependence. Bax immunohistochemistry can be used as a basis for the morphological diagnosis identified by forensic identification.