The relationship of a high level of serum beta-hydroxybutyrate to cause of death
The relationship of a high level of serum beta-hydroxybutyrate to cause of death
复制标题
DOI：
10.1016/j.legalmed.2005.01.003
复制
发表时间：
2005-05-05
期刊：
影响因子：
1.5
通讯作者：
Funayama, Masato
中科院分区：
文献类型：
--
作者：
Kanetake, Jun;Kanawaku, Yoshimasa;Funayama, Masato
为了检查酮症酸中毒状态与死因的关系，在死后血清中测定了三种酮体（乙酰乙酸、β-羟基丁酸和丙酮）。在100例尸检病例中，22例有酮体增加的病理生理条件，在某些情况下重叠，即营养不良状态（10例），酒精性脂肪肝损害（10例），糖尿病（5例）和感染性疾病（5例）。在β-羟基丁酸酯浓度大于10，000、1000- 10，000、500-1000和200-500 μ mol/l的3、11、7和15例病例中，分别有3例（100%）、8例（73%）、3例（43%）和5例（33%）存在一种或多种通常产生酮体的病理生理学状况。在β-羟基丁酸浓度低于200 μ mol/l的64例病例中，只有3例（5%）出现上述情况。显示高水平酮体的病例往往具有可产生酮体的病理生理状态，尽管β-羟基丁酸水平和这些状态未显示平行关系。当尸检结果无法解释死因时，如果血清β-羟基丁酸酯水平超过1000 μ mol/l且身体存在倾向于增加酮体的病理生理学状况，则诊断为酮症酸中毒导致的死亡是合理的。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
To examine the state of ketoacidosis in relation to the cause of death, three kinds of ketone bodies (acetoacetate, beta-hydroxybutyrate and acetone) were measured in postmortem serum. Of 100 autopsy cases, 22 had ketone body increasing pathophysiological conditions, overlapped in some cases, namely a poorly-nourished state (10 cases), alcoholic fatty liver damage (10), diabetes (5) and infectious disease (5). Of the 3, 11, 7 and 15 cases in which the beta-hydroxybutyrate concentration was greater than 10,000, 1000-10,000, 500-1000 and 200-500 mu mol/l, 3 (100%), 8 (73%), 3 (43%) and 5 (33%), respectively, had one or more pathophysiological conditions that usually produce ketone bodies. Of the 64 cases in which the beta-hydroxybutyrate concentrations were less than 200 mu mol/l, only 3 (5%) had some of these conditions. Cases showing high levels of ketone bodies tended to have pathophysiological states that can produce them, although the level of beta-hydroxybutyrate and these states did not show parallel relationships. When autopsy findings fail to explain the cause of death, a diagnosis as death caused by ketoacidosis would be reasonable if the serum beta-hydroxybutyrate level is over 1000 mu mol/l and the body has pathophysiological conditions that tend to increase ketone bodies. (c) 2005 Elsevier Ireland Ltd. All rights reserved.