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Interpretation of drug concentrations in pericardial fluid, cerebrospinal fluid and vitreous humor

心包液、脑脊液和玻璃体液中药物浓度的解读

基本信息

批准号：
11670419
负责人：
MORIYA Fumio
金额：
$ 1.54万
依托单位：
Kochi Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1999
资助国家：
日本
起止时间：
1999 至 2000
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11670419/
关键词：
Forensic toxicology Postmortem blood drug concentration Pericardial fluid Cerebrospinal fluid Vitreous humor Drug analysis Postmortem redistribution Gas chromatograph

项目摘要

Drug-involved forensic autopsy cases in which cerebrospinal fluid, vitreous fluid, pericardial fluid and blood samples (pulmonary arterial and venous blood, cardiac blood, aortic blood, inferior vena caval blood and femoral venous blood) were obtained and in which no obvious putrefaction was observed were selected in this study. Although blood drug concentrations were very site dependent, drug concentrations in blood from the right cardiac chambers were quite similar to those in femoral venous blood. The correlations of drug concentrations between femoral venous blood and pericardial fluid were better than those between blood and cerebrospinal fluid/vitreous humor. However, some cases showed relatively large differences in drug concentrations between blood and pericardial fluid. Drug concentrations in femoral venous blood were compared with concentrations in average drug concentrations in cerebrospinal fluid, vitreous humor and pericardial fluid, and the average concentrations between all possible pairs among these three fluids. The ratios between average cerebrospinal fluid/pericardial fluid drug concentration and femoral venous drug concentration was very close to 1 (O.94±O.20, n=16). We established following criteria for objectively judging whether drug concentrations determined in postmortem blood are usable for toxicologic evaluation : 1) when the ratio of average cerebrospinal fluid/pericardial fluid drug concentration to blood drug concentration is within a range of 0.6-1.4, the postmortem blood drug concentration is usable for toxicologic evaluation ; and 2) when the ratio is outside the range, the average cerebrospinal fluid/pericardial fluid drug concentration should be used as an alternative to drug concentration in postmortem blood.

本研究选取了采集了脑脊液、玻璃体液、心包液和血液标本（肺动静脉血、心脏血、主动脉血、下腔静脉血、股静脉血），且未观察到明显腐败的涉毒法医尸检病例。尽管血药浓度具有很强的部位依赖性，但右心腔血液中的药物浓度与股静脉血液中的药物浓度非常相似。股静脉血与心包液药物浓度的相关性优于血液与脑脊液/玻璃体液药物浓度的相关性。然而，一些病例显示血液和心包液之间的药物浓度差异相对较大。将股静脉血中的药物浓度与脑脊液、玻璃体液和心包液中的平均药物浓度以及这三种液体中所有可能对之间的平均浓度进行比较。平均脑脊液/心包液药物浓度与股静脉药物浓度之间的比值非常接近于1（0.94 ± 0.20，n=16）。我们建立了客观判断死后血药浓度是否可用于毒理学评价的标准：（1）当脑脊液/心包液平均药物浓度与血药浓度之比在0.6-1.4范围内时，死后血药浓度可用于毒理学评价; 2）当比值超出范围时，应使用脑脊液/心包液平均药物浓度作为死后血液中药物浓度的替代。