一氧化碳中毒血分光光度定量分析法比较

目的比较7种一氧化碳中毒血样分光光度含量测定方法的特点及适用性。方法用空白血添加一氧化碳配制不同浓度的样品,采用双波长法、还原法（3种）、切线法和导数光谱法（2种）进行检测,对各种方法线性范围、重现性和操作中注意事项等内容进行考察,并用实际案件检材验证和比较。结果还原法一在30%~70%、还原法三在20%~100%,其他方法在20%~70%范围内,线性关系良好;样本浓度超过或低于50%,采用切线法有一定误差;导数法及还原法三因需要制备CO饱和样本,操作略微繁琐,但导数光谱法计算结果准确性好。结论几种方法均可用于一氧化碳中毒血的检测,实验结果可为方法的实际应用提供借鉴和帮助。     

一阶导数光谱法直接测定血中一氧化碳成分的研究

本文采用一阶导数光谱法直接测定血中一氧化碳含量,线性范围10％～90％。该法无须添加还原剂,操作简便、快速,且稳定性好,不仅适于一氧化碳中毒死亡尸体的检验,而且适于一氧化碳中毒较轻患者的检验。     

甲醇中毒机制的研究进展

甲醇经口或皮肤吸收入血后造成中毒者双目失明甚至死亡等严重后果的案件时有发生。甲醇及其代谢产物甲醛、甲酸均可对机体产生严重毒性作用,引起代谢性酸中毒、视力障碍及神经症状。目前对于甲醇中毒机制的研究主要集中在甲醇氧化代谢过程中形成的甲醛、甲酸及大量自由基直接或间接地造成组织细胞缺氧,结构及生物特性改变,自由基及抗氧化系统、蛋白酶及蛋白酶抑制系统平衡被打破,而造成体内一系列中毒改变。     

尸体内一氧化碳存在的分析及法医学意义

一氧化碳中毒一般多见于意外事故。近年来利用一氧化碳自杀、谋杀案时有发生，特别是利用煤气管道开放杀人后又伪装火灾的案例屡见不鲜。因此，检测尸体中是否含有碳氧血红蛋白（HbCO）及其含量多少，常是提示一氧化碳中毒致死或是死后一氧化碳侵入的重要依据。为能正确分析判断死因，应对一氧化碳中毒的复杂性、可变性及尸体中一氧化碳产生的原因等有较全面的了解。一、溺水尸体中一氧化碳的产生与判断尽管溺水尸体血液及体液中经常检出较高HbCO，但不能由此盲目判断为生前CO中毒。K0jima等“’曾做了CO死后形成的实验研究。即将溺死…     

95例尸体血中HbCO％的分析

血中碳氧血红蛋白饱和度(简称HbCO％,下同)含量是判断一氧化碳中毒,推断火灾中尸体生前状态的依据。本文证明:血中HbCO％与其年龄、性别及不同情况下CO中毒有关。一氧化碳中毒的尸体含量较高(平均大于60％);火灾事故中遇难的尸体含量中等(平均在30～50％);而被杀后投入火场或服毒后自焚则较低(平均小于20％)。     

血液样品中防腐剂对碳氧血红蛋白稳定性的影响

目的研究临床上常用8种试剂对血液样品中碳氧血红蛋白(HbCO)稳定性的影响。方法将血液样品分为高、低两个HbCO浓度组,选用临床常用的甲醛、氟化钠、乙二胺四乙酸二钠、亚硝酸钠、草酸钾、肝素钠、柠檬酸钾及氟化钠与草酸钾混合物(1:3)8种试剂,按常用浓度分别添加到血样品中,并于添加后0h、2h、8h、24h、3d、7d用紫外可见光分光光度法检测其中HbCO饱和度,用统计学方法进行结果分析。结果本实验选用的8种试剂只有甲醛和亚硝酸钠对HbCO的稳定性影响较为显著,而其余6种对HbCO稳定性的影响无统计学意义。结论在检验疑似CO中毒并经甲醛或亚硝酸钠防腐的检材时应慎重,以免导致错误的鉴定结论。     

Matlab软件编程直接计算碳氧血红蛋白饱和度

检验血液中碳氧血红蛋白饱和度越来越多地应用仪器进行定性、定量分析,其中紫外光谱法由于简单、方便,应用较普遍。但该法需要对所得到的紫外光谱图进行手工测量计算,常常产生较大的误差。本文采用Matlab软件,根据碳氧血红蛋白饱和度的计算方法编写了一个程序,消除了这种人为的误差,并实现了测量过程的自动化,且计算快速、简便。Mat-lab软件计算功能强大,提供了一种演算纸方式的编程语言,已成为科学研究和工程计算的基本技能[1,2],但在法庭物证科学中的应用还很少,现报道如下。1一氧化碳中毒血紫外吸收光谱图取0.2ml检血,加适量的蒸馏水稀…     

不同来源一氧化碳中毒死亡者血液中COHb含量分析

目的探索一氧化碳中毒存在的个体差异性,分析女性可能存在的抵御一氧化碳中毒的机制。方法收集207例不同来源的一氧化碳中毒死亡者血液,测量COHb含量,将案例按照不同的因素分类进行统计学分析。结果不同一氧化碳的来源对于死者的COHb浓度影响显著,而性别对于COHb浓度影响不显著,少年儿童和老年人有可能对COHb的抵御能力差于成年人。     

顶空气质联用法测定腐败血、肝检材中CO

目的研究CO中毒腐败血、肝组织检材中CO的HS/GC/MS检测。方法用HS/GC/MS法分析碳氧血红蛋白(COHb)血的线性范围。配制10%、30%、50%、70%浓度COHb血样,分别在室温、冷藏、冷冻条件下保存,分别在当日、第4、14、45d进行测定,比较实验结果。腐败肝组织由雄性健康家兔通CO气体致死,当天解剖,家兔肝常温隔绝空气保存并放35d至腐败,期间进行不定期顶空测定分析。结果制备的COHb血在0-100%之间有良好的线性关系Y=2.4X+2.2(r=0.9995)。以此方法测定家兔CO中毒致死的COHb新鲜血的浓度和4℃下放置45dCOHb腐败血,结果表明温度对血样中COHb%的测定影响最大。采用HS/GC/MS法检测,每次只需0.25ml血样或1g肝脏,分析一次时间只需3min,均可检测出新鲜检材和常温放置45d的腐败肝组织检材CO的含量。结论HS/GC/MS法能检出CO中毒的腐败生物检材中CO。     

血、尿中金属毒物的电感耦合等离子发射光谱检测方法

目的建立血和尿中的有毒金属元素快速检测方法。方法通过模拟样品,采用微波消解炉对样品进行预处理,用电感耦合等离子发射光谱仪同时对多种可疑有毒金属元素进行检测。结果血、尿样品经消解或酸稀释处理,镉、钴、铬、铜、镍等元素可检测方法平均回收率范围为75.5%～127.5%,变异系数小于16.4%结论在中毒剂量,对肝脏和肾脏组织中的可疑有毒金属元素,可以采用电感耦合等离子发射光谱仪同时进行检测。     

The role of hydrogen cyanide and carbon monoxide in fire casualties: a prospective study

Determinations of blood cyanide and carboxyhemoglobin concentrations were performed in 18 victims found dead in buildings after fires during a 2-year period. The results indicated that 50% of the victims had been exposed to toxic levels of hydrogen cyanide and 90% to toxic levels of carbon monoxide. Lethal concentrations of carbon monoxide were found in 83% of the victims. In one case a lethal blood cyanide but a non-toxic blood carboxyhemoglobin value was found. It is concluded that carbon monoxide appears to be more important than hydrogen cyanide as a toxic agent in the fire atmosphere, but cyanide poisoning without carbon monoxide poisoning may, under certain circumstances, be the cause of death in fire victims.     

A study on house fire victims: age, carboxyhemoglobin, hydrogen cyanide and hemolysis.

Correlation among age, concentrations of carboxyhemoglobin and hydrogen cyanide, oxygen density and hemolysis were studied in 120 house fire victims. Victims aged over 60 years comprised approximately 50% of the pooled subjects. Blood samples were mainly collected from the left ventricle, but sometimes from both the right and left ventricles. The concentration of carboxyhemoglobin ranged from 1-95%, of which 71 persons (59.7%) died with carboxyhemoglobin concentrations below 60%. Carboxyhemoglobin concentrations below 10% were found in 9 persons (7.5%). Most of these cases involved the elderly persons. In this paper, we report on the death of elderly victims as a result of low carboxyhemoglobin concentrations. A significant correlation of blood carboxyhemoglobin concentrations existed between the right and left ventricles. The concentration of carboxyhemoglobin in the left ventricle was significantly higher than that in the right. Two out of 31 victims whose hydrogen cyanide concentrations were determined, succumbed to hydrogen cyanide poisoning, having a high concentration of hydrogen cyanide and a low concentration of carboxyhemoglobin. On analysis, oxygen density was found to be low in 13 persons. A negative correlation was shown between carboxyhemoglobin concentration and hemolysis. Inasmuch as hemolysis may indicate the extent of heat dissociation, hemolysis should provide an index of carbon monoxide dissociation from carboxyhemoglobin. In the present study of victims, possible causes of death i.e., carbon monoxide gas poisoning, hydrogen cyanide poisoning, oxygen deprivation, burning, shock due to burns and others were estimated. The survival time for elderly victims was considered to be short.     

The stability of several compounds in formalin fixed tissues and formalin-blood solutions

Buffered formalin solutions were added to spiked blood samples containing diazepam, phenytoin, carbon monoxide and cyanide to give formalin-whole blood solutions of 5 and 8%. Sections of liver positive for desipramine, phenobarbital and phenytoin were placed in separate 5 and 8% formalin-water solutions. The formalin-blood solutions were monitored daily for 30 days, while the fixed liver and formalin-water samples were analyzed once a week for 4 weeks. In the formalin-blood solutions losses were found for diazepam and phenytoin over the 30-day period of at least 41% and 33%, respectively. Cyanide detection was not possible immediately after the addition of formalin and the presence of carboxyhemoglobin was difficult to detect after 1 week. In the liver, losses of phenobarbital and desipramine were greater than 60% while phenytoin showed little change. This study has revealed that the drugs examined at toxic concentrations can be detected, with variable recoveries, for up to 30 days after fixation with formalin. However, quantitative analysis for cyanide and carboxyhemoglobin may be significantly impaired in the presence of formaldehyde.     

Fetal death due to nonlethal maternal carbon monoxide poisoning

Fetal death due to acute carbon monoxide poisoning is rarely reported in the medical literature. Of the eight cases found in literature review, only one documented the fetal carboxyhemoglobin concentration. This paper reports a fetal death due to accidental nonlethal maternal carbon monoxide intoxication in which both maternal and fetal carboxyhemoglobin concentrations were obtained. The corrected carboxyhemoglobin concentration was 61% at the time of death in utero, while the maternal carboxyhemoglobin was measured at 7% after one hour of supplemental oxygen. The authors review the mechanisms of fetal death and emphasize the different carbon monoxide kinetics in the fetal circulation.     

顶空气相色谱法测定生物组织中的一氧化碳

本文主要研究用顼空气相色谱法测定生物检材中的一氧化碳。分析一个样品只需三分钟即可完成。本法不但适用于血样检材,而且适用于生物组织,甚至腐败生物检材,对于血液样品的最小检测量为50μl,变异系数为0.023。本文研究的方法已成功地应用于法庭科学一氧化碳中毒案件的检验。并描述了贮存的方法。     

Comparison of Different Analytical Methods for the Determination of Carbon Monoxide in Postmortem Blood

The determination of carbon monoxide (CO) and carboxyhemoglobin (COHb) is of utmost importance in forensic toxicology to determine the cause of death in cases of CO poisoning, fire, and explosions. To this end, reliable and updated analytical methods are required. In this paper, four different methods for the determination of carbon monoxide in postmortem blood samples were compared: (i) the spectrophotometric determination of COHb applying the method proposed by Rodkey and modified by Beutler–West, (ii) the spectrophotometric determination of CO using a micro-diffusion-based method, (iii) the determination of CO by gas chromatography coupled to a TCD detector, and (iv) the determination of COHb by blood gas analysis. Three postmortem blood samples were analyzed with all methods, and the results were comparable. The applied methodologies showed different features depending on the sensitivity, sample preparation, and volume. The HS-GC/TCD method in our hand was the most appropriate, on postmortem samples, and versatile to apply. Unfortunately, only a limited number of postmortem blood samples were available for this study due to the rarity of that kind of intoxication in our jurisdiction.     

The causes of death in fire victims

In 169 consecutive cases of autopsied fire victims about 50% had lethal levels of carboxyhemoglobin. Soot in the respiratory tract was found in about 90% of the cases. The age distribution of the fire victims showed significantly less persons in the 15-35-year group than should be expected according to the age distribution of the population, presumably due to greater agility of younger people. More than half of the fire victims had alcohol in the blood exceeding 0.05%, and alcohol intoxication should be considered accessary to many deaths in fire. The characteristic biphasic distribution of carboxyhemoglobin in fire victims together with other observations suggest that the principal causes of death are carbon monoxide followed by carbon dioxide poisoning and/or oxygen deficiency, while the influence of heat is considered to be of minor importance.     

A New Approach for the Carbon Monoxide (CO) Exposure Diagnosis: Measurement of Total CO in Human Blood Versus Carboxyhemoglobin (HbCO)

The aim of the study is to present the application of a headspace–gas chromatography–mass spectrometry (HS‐GC‐MS) method for the determination of the carbon monoxide (CO) blood concentration and to compare it with carboxyhemoglobin (HbCO) saturation. In postmortem cases, the HbCO measured by spectrophotometry frequently leads to inaccurate results due to inadequate samples or analyses. The true role of CO intoxication in the death of a person could be misclassified. The estimation of HbCO from HS‐GC‐MS CO measurements provides helpful information by determining the total CO levels (CO linked to hemoglobin (HbCO) and CO dissociated from hemoglobin). The CO concentrations were converted in HbCO saturation levels to define cutoff blood CO values. CO limits were defined as less than 1 μmol/mL for living persons, less than 1.5 μmol/mL for dead persons without CO exposure, and greater than 3 μmol/mL for dead persons with clear CO poisoning.     

Death scene evaluation in a case of fatal accidental carbon monoxide toxicity

Exposure of humans to high concentrations of carbon monoxide can result in death, due to the formation of carboxyhaemoglobin (COHb), which impairs the oxygen carrying capacity of the haemoglobin. Carbon monoxide is responsible of a great number of accidental domestic poisonings and deaths throughout the world, particularly in homes that have faulty or poorly vented combustion appliances. A case is reported, in which a 21-year-old woman was found dead, due to carbon monoxide poisoning from a gas water heater, despite the puzzling evidence that the heater has been used for more than 10 years without any problem. An evaluation of the exposure to CO was performed, by measuiring the rate of production of CO from the heater, and using the Coburn-Forster-Kane equation to describe the kinetics of the poisoning process. The death was attributed to an accidental poisoning from carbon monoxide due to a sum of unfortunate circumstances.