Postmortem Detection of Isopropanol in Ketoacidosis
Postmortem Detection of Isopropanol in Ketoacidosis
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DOI：
10.1111/j.1556-4029.2011.02045.x
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发表时间：
2012-05-01
影响因子：
1.6
通讯作者：
Harruff, Richard
中科院分区：
文献类型：
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作者：
Petersen, Thomas H.;Williams, Timothy;Harruff, Richard
在糖尿病酮症酸中毒（DKA）或酒精性酮症酸中毒（AKA）导致的死亡中检测到的异丙醇（IPA）可能引起IPA中毒的担忧。本研究在对260例死亡病例进行的15年回顾性审查中解决了这一问题，其中比较了DKA（175例）、AKA（79例）和IPA中毒（6例）中丙酮和IPA的浓度及其比值。结果表明，当没有IPA摄入的证据时，在酮症酸中毒中检测到IPA的频率。在77%的DKA病例中可检测到IPA，平均可定量浓度为15.1 +/- 13.0 mg/dL;在52%的AKA病例中，平均可定量浓度为18.5 +/- 22.1 mg/dL;在IPA中毒病例中，平均可定量浓度为326 +/- 260 mg/dL。IPA的产生与死亡时间呈弱相关（r = -0.48）。尽管IPA浓度在摄入后要高得多，但在DKA中可达到潜在的毒性浓度，而无需已知的摄入。
Isopropanol (IPA) detected in deaths because of diabetic ketoacidosis (DKA) or alcoholic ketoacidosis (AKA) may cause concern for IPA poisoning. This study addressed this concern in a 15-year retrospective review of 260 deaths in which concentrations of acetone and IPA, as well as their ratios, were compared in DKA (175 cases), AKA (79 cases), and IPA intoxication (six cases). The results demonstrated the frequency of detecting IPA in ketoacidosis when there was no evidence of IPA ingestion. IPA was detectable in 77% of DKA cases with quantifiable concentrations averaging 15.1 +/- 13.0 mg/dL; 52% of AKA cases with quantifiable concentrations averaging 18.5 +/- 22.1 mg/dL; and in cases of IPA intoxication, averaging 326 +/- 260 mg/dL. There was weak correlation of IPA production with postmortem interval in DKA only (r = -0.48). Although IPA concentrations were much higher with ingestion, potentially toxic concentrations were achievable in DKA without known ingestion.