超高效液相色谱-质谱法测定人全血中甲胺磷、乙酰甲胺磷含量

目的应用超高效液相色谱-质谱法(UPLC-MS/MS)对人全血中甲胺磷、乙酰甲胺磷进行定量测定。方法采用去离子水直接稀释人全血,提取血中的甲胺磷及乙酰甲胺磷,以甲醇-水(含0.1%甲酸)为流动相梯度洗脱,正离子化多反应监测(MRM)模式测定。结果甲胺磷、乙酰甲胺磷的回收率均高于87%。在选定条件下全血中甲胺磷、乙酰甲胺磷的线性范围为2～200ng/ml,最小定量限为2ng/ml。结论将全血样品进行直接稀释并应用液相色谱-质谱法进行检测可作为甲胺磷及乙酰甲胺磷中毒的快速检测方法。     

血浆中水杨酸的高效液相色谱分析

目的 建立血浆中水杨酸的高效液相色谱快速分析方法。方法 以正常人血浆添加标准水杨酸对血浆样品的前处理方法、仪器测试条件、线性范围、精密度、回收率进行全面考查,对单剂量口服乙酰水杨酸缓释片的健康受试者血液中代谢成份水杨酸进行浓度监测。结果 该方法在血浆中的线性范围是0.05～4.0μg/mL;最低检测浓度为0.05μg/mL;日内、日间精密度分别小于4.3％和5.2％;回收率在97.2％-101.7％。结论 所建方法迅速、灵敏,可在1.5h内完成血浆中SA的检测,并可准确监测至服药后36h的血代谢浓度值。     

家兔血液和尿液中氯胺酮浓度的相关性

目的研究家兔尿液中氯胺酮及代谢物去甲氯胺酮浓度与血药浓度的动态相关性。方法实验家兔分为氯胺酮灌胃组、静脉注射组和对照组,分别于染毒前和染毒后不同时间点收集尿液和血液。气相色谱/质谱联用(GC/MS)全扫描定性、气相色谱(GC)定量分析血液和尿液样品中氯胺酮及去甲氯胺酮的浓度。采用双变量Pearson相关分析研究尿液中药物浓度和血药浓度的相关性。结果氯胺酮灌胃组和静脉注射组给药后各时间点氯胺酮及去甲氯胺酮在尿液和血液中的浓度相关系数范围在0.11～0.69之间。结论氯胺酮及去甲氯胺酮在尿液和血液中的浓度相关性较差,尿液药物浓度并不能直接反映血药浓度,因此用尿液中氯胺酮浓度推断血药浓度时应慎重考虑。     

家兔唾液与血液中氯胺酮浓度的相关性

目的研究家兔唾液中氯胺酮及代谢物去甲氯胺酮浓度与血药浓度的相关性。方法实验家兔分为氯胺酮灌胃组（6只）、静脉注射组（6只）和对照组（6只）,分别于染毒前、后不同时间点收集唾液和血液。采用气相色谱/质谱联用（GC/MS）全扫描定性、气相色谱（GC）定量分析样品中氯胺酮及去甲氯胺酮的浓度。采用双变量Pearson相关分析研究唾液中药物浓度和血药浓度的相关性。结果氯胺酮灌胃组和静脉注射组给药后各时间点氯胺酮及去甲氯胺酮在唾液和血液中的浓度相关系数（r）范围为0.80-0.95。结论氯胺酮及去甲氯胺酮在唾液和血液中的浓度均有良好的相关性,根据唾液药物浓度推断血药浓度可用于氯胺酮滥用的法医学鉴定。     

8例利多卡因过敏性休克死的血药浓度分析

目的研究利多卡因过敏性休克死者利多卡因血药浓度及其与死因的关系。方法采用高效液相色谱法(HPLC),分别对使用利多卡因麻醉术中各项指标均正常的8例术中因利多卡因过敏性休克死者的血液和11例顺利完成手术患者的血液进行利多卡因浓度的检测,对比分析两者结果。结果 8例死者利多卡因血药浓度(1．61mg± 0．45mg／L)低于11例正常患者利多卡因血药浓度(2．44mg±0．47mg／L)。结论利多卡因过敏性休克死者血药浓度在正常值范围内,与发生过敏性休克致死无关。     

唾液中滥用药物分析及其与血液中药物浓度的相关性

唾液是一种成分简单、易于采集的体液,某些药物在唾液中的浓度可以反映其血药浓度。本文分析了滥用药物进入唾液的机制和影响因素,综述了唾液中滥用药物分析时样品的采集、前处理和检测方法以及唾液与血液中药物浓度的相关性。认为唾液是临床和法医学方面很有价值的分析样品,用唾液中滥用药物浓度来推测血药浓度具有一定的法医学意义。     

唾液与血液中海洛因代谢物的检测时限

目的比较唾液与血液中海洛因代谢物吗啡和O6-单乙酰吗啡的检测时限,为实际检测时选择样本采集时间提供依据。方法将实验大耳白兔分为3组,通过耳缘静脉注射浓度为2.6mg/m L的海洛因溶液,给药量分别为0.5m L,1m L,2m L。给药后于0.5~48h期间采集静脉血液;给药后于3~48h采唾液。采用超高效液相色谱串联质谱法,分别检测各时间点,各组不同种类样本中的海洛因代谢产物吗啡和O6-单乙酰吗啡。结果 1O6-单乙酰吗啡在血液中的检测时间为6h(给药量2.6mg和5.2mg)和1.5 h(给药量1.3mg),9h后已检测不到;而唾液样本在24h时虽下降明显,但3种给药剂量下均仍可检出,至48h时均不能检出;2吗啡在血液和唾液中不能检出的时间分别为24h和48h。结论血液中O6-单乙酰吗啡和吗啡的检测时限随用药量的增加而延长,而在唾液的检测时限均明显比在血液中更长久。该结果可作为实际检测时根据样本种类和选择采集时间的依据。     

人血浆中氟康唑的高效液相色谱分析

目的建立血浆中氟康唑的高效液相色谱分析方法。方法以正常空白人血浆添加标准氟康唑及内标物对样品的前处理方法、仪器测试条件、定性定量分析方法进行考察和优化。对10名健康受试者单剂量口服氟康唑的药代谢动力学进行测定。结果血浆中氟康唑在0.25~10.0μg/ml范围内线性关系良好(r=0.9986);定量检测的浓度下限是0.25μg/ml;检出限为0.1μg/ml;分析方法的精密度日内RSD≤2.9%、日间RSD≤8.3%(n=5);氟康唑在血液中的相对回收率在97.0±2.8%和108.4±2.4%之间;结论所建高效液相色谱分析方法准确、便捷,适应于法医学鉴定、临床血药浓度监测和药代动力学研究。     

有机磷农药中毒的人体血液致死浓度探讨

对 4年间 6家医院所有门急诊有关敌敌畏、甲胺磷、乐果三种有机磷农药中毒病例进行了调查分析。运用气相色谱法对其血液中的浓度进行测定。采用 Bliss法,计算其死亡率和昏迷率的加权直线回归方程,并获得其经救治后血液半数致死浓度 LC50、半数致昏迷浓度 CC50。综合文献和临床实践,认为及时的救治对中毒病例的治疗转归有较大影响,其自然的血液半数致死浓度应在经救治的半数致死浓度 LC50和半数致昏述浓度之间。综合半数致死浓度和半数致昏迷浓度,计算其自然的半数致死浓度 LCe50值。     

甲胺磷在家兔血保存标本中的分解动力学研究

研究甲胺磷中毒死的检血在保存中的甲胺磷分解动力学。甲胺磷中毒死的家兔血分别在室温（12～25℃）及冰箱（4℃）保存,并用气相色谱－火焰光度检测器测定不同时间的浓度。在室温及冰箱中,甲胺磷在家兔血保存标本中的分解初始很快,随时间延长,分解趋于缓。队分解曲线类似动力学静注二室模型。甲胺磷在室温保存组中的分解较冰箱中快。该研究为正确判断甲胺磷中毒的分析结果提供了参考依据。     

Acephate in biological fluids of two autopsy cases after ingestion of the chemical

Two autopsy cases, where the individuals were suspected of having ingested acephate, an organophosphorous insecticide, are reported. Acephate and its active metabolite, methamidophos (MP), were analyzed in the biological fluids by GC/MS, using the salting out method with liquid-liquid extraction columns. The first case was that of a 70-year-old man whose blood acephate was 149 microg/mL, and MP was 3.0 microg/mL. Serum pseudocholinesterase (ChE) activity was inhibited. No remarkable finding of injury or disease was determined as the cause of his death, but acute poisoning by acephate was mostly suspected. The second case was that of a 60-year-old man. A deep gash in the left neck injured the left common carotid artery in addition to the severely ischemic state of the primary organs. His blood acephate was 46 microg/mL, and MP was not detected. ChE activity was in the normal range. Hemorrhage was mainly suspected as the cause of his death. The concentrations of acephate and MP in human blood after oral ingestion are first reported here, and the acute toxic level of acephate is discussed.     

Fatal and non-fatal methomyl intoxication in an attempted double suicide

A 79-year-old man and his 73-year-old wife attempted double suicide by ingesting methomyl powder. The woman died 19 h after ingestion in spite of intensive care. At autopsy a large number of miliary hemorrhages were found in both thalami of the brain. Her husband, however, recovered after 10 days of treatment. Methomyl (CAS No. 16752-77-5, Lannate) in the biological materials was analyzed by gas chromatography-mass spectrometry. The methomyl concentration was 44 micrograms/g in the wife's serum sample collected 1 h after ingestion, and 0.2 microgram/g in the blood sample collected at autopsy. The methomyl concentration in the husband's blood sample collected 28 h after ingestion was from 0.01 to 0.1 microgram/g. It is suggested that prompt and adequate intensive care including a direct hemoperfusion is necessary to effect the recovery of patients with lethal blood levels of methomyl. The miliary hemorrhages found in the thalami of the brain are suspected to have been caused by asphyxia induced by methomyl intoxication.     

Determination of dimethoate in blood and hemoperfusion cartridge following ingestion of formothion: a case study

A 57-year-old male who had ingested not more than 22 g of formothion was semicomatose on admission to hospital, approximately 1.5 h after ingestion. Dimethoate, a hydrolyzed formothion, was found in blood samples collected from the patient and in the charcoal column in the direct hemoperfusion cartridge which was used 6 to 7.5 h after ingestion. It was extracted and purified by Extrelut column extraction. A gas chromatograph, equipped with a flame photometric detector and a gas chromatograph-mass spectrometer, were used to detect and confirm the presence of dimethoate. The blood dimethoate concentrations which were taken approximately 1.5 and 6 h after ingestion were 21.4 and 12.7 micrograms/g, respectively. A blood dimethoate concentration of 21.4 micrograms/g would appear to indicate a high level of formothion intoxication. The total amount of dimethoate found in the charcoal column used was 15 mg.     

Toxicological aspects of fatal chloroquine poisoning over a period of several days

The anti-inflammatory and antimalarial drug chloroquine is said to be one of the most frequently used drugs to commit suicide in the Orient and Far East. After the ingestion of large amounts of this 4-amino-chinoline derivate, signs of cardiac conduction disturbances are evidence of cardiotoxic action. For clinical treatment, hemoperfusion by activated charcoal has rather than hemodialysis proved to be partly effective for the removal of the toxic substance. Following a suicidal overdose of chloroquine tablets in a 13-year-old boy, we could confirm the efficiency of hemoperfusion by continued toxicologic examinations. The total elimination was nevertheless slow. Due to high postmortem concentrations in the blood and tissues, we believe that chloroquine is deposited and especially concentrated in the reticulohistiocytary system of the liver. Death after 5 days of clinical treatment in this case may be referred to as the first cardiac arrest with irreversible hypoxic damage of the brain.     

Pharmacokinetic features in forensic medicine

As a rule, the concentration curves of substances in various body volumes, in particular in plasma and blood volume, can be reproduced by a number of exponentional functions. A compartment system can be isomorphically assigned to such a representation in which a mass exchange takes place between the constituent volumes. In forensic medicine (toxicology), the "central compartment model" is used in which an exchange of substances between the blood space (central compartment) and the peripheral spaces (peripheral compartments) takes place. Characteristic parameters of the compartment models are their volumes and the intercompartmental mass flows or their rate constants. They can be determined from the mathematical representations of the concentration curves. It is possible to obtain knowledge on the properties (e.g. permeability) of the convectional/diffusional transcapillary transport on the basis of these parameters.     

固相萃取HPLC/MS法测定血中氯硝安定

目的建立测定人血中氯硝安定的HPLC/MS定性、定量方法。方法在血液中添加氯硝安定,采用固相萃取、HPLC法分离、LC/MS法定性、定量。结果标准氯硝安定LC/MS法的工作曲线在0.5~500ng时为Y=0.655×103X+2.15×103,相关系数r=0.9981,最小检出限为0.5ng/m l。结论采用pH8.0的磷酸盐缓冲液进行稀释、C18柱固相萃取氯硝安定回收率较高,优化后固定的LC/MS检测方法简便、快速、准确,适合办案需要。     

酒精在人体内的代谢动力学研究

将16名健康男性志愿者随机分为两组，分别按含酒精0．65g／kg和0．80g／kg体重的剂量给予酒精饮料，于酒后不同时间点采取静脉血样。用乙醇脱氨酶（ADH）氧化分析法测血样酒精浓度（BAC），所得浓度-时间数据经用药代动力学软件分析拟合。结果表明，酒精在人体内的代谢符合非线性消除伴一级吸收的一室开放模型。据此，作者建立了描述酒精在人体内动态变化规律的数学模型。经验证，该模型符合度良好，可用于司法实践。     

Palliative pain therapy at the end of life and forensic medicine issues.

An 83-year-old woman with a history of Alzheimer's disease and breast cancer died at home while receiving palliative pain therapy with oral morphine from her family for metastatic breast cancer. Allegations of mistreatment were made, and this case was ultimately referred to the Office of the Chief Medical Examiner, State of Maryland. An autopsy failed to identify any injuries or residual cancer, leaving no anatomic explanation for the pain that had been presumed to be metastatic breast carcinoma involving bone. The blood free morphine concentration was 5,200 ng/ml, and the total morphine concentration was 15,000 ng/ml. This case demonstrates the challenges and difficulties in forensic medicine when faced with the interpretation of toxicologic results at the end of life.     

人体不同体液内PSA含量及其法医学意义

目的检测人体不同体液内前列腺特异抗原(PSA)含量,探讨其法医学价值。方法收集成年人(19～63岁)晨尿40份(男28份、女12份)、血液58份(男45份、女13份)、唾液25份(男14份、女11份);青少年(10～15岁)男性晨尿205份;哺乳期(25～31岁)女性乳汁9份;使用Cobas e411型全自动电化学发光免疫分析系统及T-PSA定量测定试剂盒,检测各样本T-PSA含量;分析不同体液及不同年龄青少年男性尿液PSA含量差异。结果除男、女性唾液外,其它样本均可检测到PSA,其中成年男性尿液含量最高,与其它体液比较具有显著性差异(P<0.000 1);青少年男性各年龄组尿液PSA含量随年龄逐年增高,11岁及以下年龄组含量不足1ng/mL,14岁及以上年龄组可超过1 000ng/mL。结论前列腺发育成熟的男性尿液PSA含量较高,在进行精液斑的法医学检验时应给予充分注意。