Objective To study the neuron apoptosis and expression of caspase3 in the brainstem of the victims died from primary brainstem injury. Methods Neuron apoptosis and expression of caspase3 in dorsal nucleus of vagus nerve and reticular formation were evaluated quantitatively at different posttraumatic time points (t≤ 5min; 5min 28% ) could be seen by immunohistochemical staining in the brainstem after injury, which increased in number with extension of posttraumatic interval. Conclusion The detection of neuron apoptosis and expression of caspase3 in the brainstem can provide a morphological method for diagnosis of PBSI in forensic pathology.%目的 观察原发性脑干损伤( PBSI)致死者脑干神经元凋亡及caspase3的表达情况,探讨其法医学意义.方法 选择法医学检案中30例确定为原发性脑千损伤致死者脑干,按伤后不同存活时间(t≤5min、5min＜t≤15min、15min＜ t≤1h、1h＜t≤24h)分为4组,以5例非脑干损伤死亡者脑千为对照组；分别运用常规HE、免疫组化和TUNEL染色检测中脑、桥脑及延脑重要核团内神经元凋亡及caspase3的表达情况.结果 原发性脑干损伤后15min～24h出现明显神经元细胞凋亡(23.2％～35.9％)和caspase3阳性表达(28％～54％),并呈现随损伤时间进行性增加的趋势,与对照组有显著性差异(P＜0.01).结论 原发性脑干损伤早期即出现神经元凋亡及caspase3表达增加,并随损伤时间的延长呈进行性增加,可据此辅助诊断原发性脑干损伤死亡.
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