CAJ | 학술논문

目的：研究电击死者心脏窦房结组织中超极化激活环核苷酸门控阳离子通道4（hyperpolarization－activated cyclic nucleotide－gated cation channel 4，HCN4）及连接蛋白43（connexin43，Cx43）表达的变化。方法选择2010—2013年徐州医学院病理学教研室尸体解剖中有明确电流斑的电击死者34例作为电击死组，并设交通事故颅脑损伤死者20例作为对照组。应用免疫组织化学法检测HCN4和Cx43在心脏窦房结组织中的表达。结果 HCN4阳性细胞表达于窦房结细胞膜及细胞质中，Cx43阳性细胞表达于窦房结T细胞及心肌细胞的细胞膜及细胞质中。电击死组HCN4的表达高于对照组（P<0．05），Cx43的表达低于对照组（P<0．05）。结论电击死者窦房结组织中HCN4和Cx43表达的变化，说明电击死可能与心脏电生理的改变及冲动传导改变有关。
목적：연구전격사자심장두방결조직중초겁화격활배핵감산문공양리자통도4（hyperpolarization－activated cyclic nucleotide－gated cation channel 4，HCN4）급련접단백43（connexin43，Cx43）표체적변화。방법선택2010—2013년서주의학원병이학교연실시체해부중유명학전류반적전격사자34례작위전격사조，병설교통사고로뇌손상사자20례작위대조조。응용면역조직화학법검측HCN4화Cx43재심장두방결조직중적표체。결과 HCN4양성세포표체우두방결세포막급세포질중，Cx43양성세포표체우두방결T세포급심기세포적세포막급세포질중。전격사조HCN4적표체고우대조조（P<0．05），Cx43적표체저우대조조（P<0．05）。결론전격사자두방결조직중HCN4화Cx43표체적변화，설명전격사가능여심장전생리적개변급충동전도개변유관。
Objective T o investigate the expression of hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (H C N 4) and connexin43 (C x43) in the sinoatrial node of electric shock death. Meth-ods As experim ental group, 34 cases of electric shock death who had definite current m ark evidence were selected from pathology departm ent of X uzhou M edical C ollege from 2010 to 2013. As the control group, 20 cases of fatal severe craniocerebral injury in traffic accidents were chosen. T he expressions of H C N 4 and C x43 in the sinoatrial node were observed by im m unohistochem ical technology. Results H C N 4 positive cells expressed in the cell m em brane and cytoplasm of the sinoatrial node. C x43 positive cells expressed in the cell m em brane and cytoplasm of T cells and m yocardial cells. T he expression of H C N 4 was significantly higher than that of the control group (P<0.05) and the expression of C x43 was signifi-cantly lower than that of the control group (P<0.05). Conclusion T he changes of H C N 4 and C x43 ex-pressions in the sinoatrial node illustrate electric shock death m ight be related to the abnorm alities of cardiac electrophysiology and conduction.