Obeject To explore the changing patterns after deaths and the possibility of diagnosing the disease during life by means of inspecting two changes of the blood biochemistry indexes (Ca2+,Serum pancreatic amylase) in 19 deaths from traffic accident (as the traffic accident death group) and 20 deaths from acute pancreatitis with hemorrhagic necrosis (as the acute pancreatitis death group) so as to identify the cause of death.Methods Subclavian vein blood was taken from all of the death cases collected by the the Judicial Authentication Center of Kunming Medical University from January 2009 to December 2010 and the plasma was tested with automatic blood biochemical analyzer.Extracted viscera tissues on autopsy were fixed with 10％ formalin liquid and Red meat-Iraq hematoxylin-eosin stain (HE) dyeing was used so as to observe the pathological morphology changes.Results Compared with the traffic accident death group,the pancreatic amylase was higher significantly in the acute pancreatitis group.The average value of pancreatic amylase was 243.47 U/L in the traffic accident death group while it was 2069.1 U/L in the acute pancreatitis death group.The numerals of the two groups were higher than that of normal living and there was statistically significant difference compared between them.Conclusion The detection of blood amylase value postmortem is beneficial to the identification of the acute pancreatitis with hemorrhagic necrosis and the diagnosis of the cause of death and it can provide some guidance on clinic and forensic science%目的 检测19例交通事故死亡组和20例急性出血坏死性胰腺炎死亡组血液中钙离子、胰淀粉酶两个血液生化指标值,探讨其死后变化规律,并探索依靠死后血液相关生化值变化诊断生前疾病、鉴定死亡原因的可能性.方法 收集昆明医科大学司法鉴定中2009年1月至2010年12月涉及交通事故的死亡案例19例和急性出血坏死性胰腺炎的死亡案例20例的锁骨下静脉血,血清全自动血液生化仪检测；尸检提取组织用10％福尔马林液浸润24 h以上进行取材,应用苏木素-伊红染色(HE)染色学方法,观察各组织病理形态学改变.结果 急性出血坏死性胰腺炎死亡病例组较交通事故死亡对照组其胰淀粉酶明显增高,交通事故死亡组胰淀粉酶平均值243.47 U/L,胰腺炎死亡组胰淀粉酶平均值2 069.1 U/L,两组数值均大于正常活体且两相比较差异具有统计学意义(P.＜0.05).交通事故死亡组、胰腺炎死亡组各组间钙离子基本在正常范围内波动,差异无统计学意义.结论 测定死后血液胰淀粉酶值的变化有助于急性出血坏死性胰腺炎的诊断和死亡原因的鉴定,可给临床及法医学提供一定的指导.
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