血中酒精消除速度与浓度推算关系的研究

目的 研究人血中酒精消除速度与血中酒精浓度的推算关系。方法 用呼气式酒精测定仪测定95位自愿受试者饮酒后一定时间内的血中酒精浓度,对时一浓曲线进行分析。结果 血中酒精的消除符合线性消除规律,消除线性相关系数为-0.989±0.011,最小值为-0.098,最大值-1.000;血中酒精消除速度为-0.140 mg·ml-1·h-1±0.028,最小值为-0.098 mg·ml-1·h-1,最大值-0.230 mg·ml-1·h-1。结论 血中酒精浓度可依据酒精消除速度[-0.10mg·ml-1·h-1]进行回推算。     

涉嫌酒后驾驶交通事故人体损伤与驾驶员血中乙醇质量浓度关系研究

目的探讨涉嫌酒后驾驶所致道路交通事故中人体损伤情况与驾驶员血中乙醇质量浓度关系,为预防、控制道路交通事故及人体损伤提供依据。方法对467例涉嫌酒后驾驶机动车的道路交通事故损伤人员相关鉴定资料与肇事驾驶员血中乙醇质量浓度进行系统分析性研究。结果涉嫌酒后驾驶发生道路交通事故的损伤人员中,以20~39岁男性居多;事故中驾驶员损伤机率最高;酒后交通事故以长头小车及摩托车最多,而驾驶员血中乙醇质量浓度（BAC）为0.1~20mg/100mL浓度的摩托车驾乘人员伤亡构成比最高;酒后驾驶机动车肇事导致的人体致命性损伤及人员死亡的饮酒组危险程度均高于未饮酒组,在驾驶员血中乙醇质量浓度（BAC）为0.1~20mg/100mL组与20.1~80mg/100mL组比较无明显差异。结论酒后驾驶肇事导致的人员伤亡比未饮酒驾车交通事故严重;未达酒后驾车组（BAC为0.1~20mg/100mL）和酒后驾车组（BAC为20.1~80mg/100mL）交通事故导致的人员伤亡无明显差异。研究结果提示,应降低饮酒后驾车血中乙醇质量浓度（BAC）法定标准阈值,进一步控制和减少道路交通事故人身伤亡率。     

运用神经行为测试系统评价酒后行为功能的可行性研究

目的研究运用神经行为测试系统评价酒后行为功能的可行性。方法采用汉化第三版计算机化神经行为评价系统(NES-C3),通过自身对照的方式,对49名饮酒者进行神经行为功能的测试,并与步行回转试验进行比较。结果心算、视觉保留、线条判断和数字筛选均在酒后0.5￣2.5h的时间点上能力指数有所下降,视简单反应时能力指数下降则延续至酒后5.5h;步行回转在酒后0.5￣2.5h间有阳性案例。血中酒精质量浓度在0.50mg/mL以上,视觉保留、线条判断及视简单反应时的能力指数有明显下降;血中酒精质量浓度在0.80mg/mL以上,心算和数字筛选的能力指数有明显下降。步行回转实验的阳性人数在血中酒精质量浓度0.50mg/mL以上有明显增加。结论计算机化神经行为评价系统作为一个定量指标,可反应酒精质量浓度与神经行为功能的关系,且比步行回转试验更客观、更灵敏。     

论道路交通事故与驾驶员血中酒精含量关系

目的探讨道路交通事故与饮酒驾车血中酒精含量关系及其法医学意义,为预防、控制道路交通事故提供重要依据。方法对2005份道路交通事故肇事驾驶员血酒精鉴定资料进行系统分析性研究。结果饮酒驾车以男性为主,女性饮酒驾车出现醉酒驾车的比例与男性无差别。市区驾驶员醉酒驾车高于郊区。驾驶员BAC<20mg/100mL肇事导致死亡的比例高于饮酒驾车肇事组(BAC20￣79mg/100ML),而BAC≥80mg/100mL则低于饮酒驾车肇事组。结论应降低饮酒驾车和醉酒驾车BAC标准,以利于减少交通事故肇事死亡率。     

SPE/UPLC法检测血中吗啡、苯丙胺类及氯胺酮

目的建立SPE/UPLC方法在同一条件下同时检测血中吗啡、苯丙胺类及氯胺酮。方法采用SCX 3cc（60mg）固相萃取柱萃取血中吗啡、MA、MDMA、MDA及氯胺酮,用超高效液相色谱（UPLC）-二极管阵列检测器（PDA）检测,结合保留时间和紫外光谱进行定性、定量分析,对实验各环节进行优化,并进行实际案例检测。结果吗啡、MA、MDMA、MDA、氯胺酮的固相萃取提取回收率分别为81.4%±2.51%、88.2%±2.48%、91.8%±2.03%、93.8%±1.46%、74.8%±2.27%,峰面积和质量浓度的线性关系良好（r〉0.999）,线性范围分别为0.08～100μg/mL、0.4～100μg/mL、0.2～75μg/mL、0.3～75μg/mL、0.4～100μg/mL,检出限分别为30pg、200pg、80pg、100pg、200pg。结论本文所建方法适用于血中吗啡、苯丙胺类、氯胺酮常见毒品的筛选及定量分析。     

腐败血液中乙醇的顶空气相色谱分析

目的分析血液腐败后产生的乙醇及其他物质并探讨腐败血液中乙醇的检测及计算方法。方法以正常人空白血液制作腐败血样,采用1,4-二氧六环为内标物,通过顶空气相色谱进行定性及定量分析。结果血中乙醇在0.0625～1mg/mL范围内线性关系良好（r^2=0.9996）,各质量浓度组的变异系数（CV%）〈2%,血中乙醇的最低检出限为1μg/mL（S/N≥3）。腐败血样所产生乙醇与正丙醇的比例大致为25：1。结论检验方法简便、准确。为法医毒化检验相关工作提供了依据。     

血中乙醇质量浓度与神经行为能力的关系

目的 研究血中乙醇质量浓度与神经行为能力的关系。方法 采用中文第三版计算机化神经行为测试评价系统（NES-C3）,通过自身对照的方式,对233名饮酒者进行神经行为能力的测试。结果 当血中乙醇质量浓度I〉0．157mg／mL时,视简单反应时和数字筛选能力指数有显著性下降;当血中乙醇质量浓度I〉0．204mg／mL时,心算、视觉保留、线条判断能力指数有显著性下降。结论 神经行为能力随着血中乙醇质量浓度的升高而下降,然后随着乙醇的不断代谢,血中乙醇质量浓度的降低,神经行为能力逐渐恢复。     

氯氮平及其代谢物在人血液中的药代动力学研究

目的研究氯氮平及其代谢物在人血液中的药代动力学和检出时限,为氯氮平中毒的法医学鉴定提供实验依据。方法 29名太原汉族人口服12.5mg氯氮平后不同时间采集肘静脉血,固相萃取法提取,超高效液相色谱-串联质谱仪分析,MRM(多反应离子检测)记录方式,保留时间和定性离子对定性,内标法和标准曲线法定量检测其中氯氮平、去甲氯氮平、氮氧氯氮平含量,3p97药代动力学软件拟合C-T数据,计算药代动力学参数。结果口服12.5mg氯氮平后,氯氮平、去甲氯氮平、氮氧氯氮平在血中动力学过程均符合一级吸收二室开放模型,达峰时间分别为2.96±1.32h、8.65±3.00h、9.31±26.38h,达峰浓度分别为34.68±9.32ng/mL、11.16±4.15ng/mL、9.62±13.88ng/mL,半衰期分别为17.02±23.63h、27.06±12.58h、41.27±29.75h,血中检出时限分别为81.72±26.19h、93.21±29.40、19.93±14.62h。结论口服氯氮平后氯氮平及其代谢物去甲氯氮平、氮氧氯氮平的药物动力学符合一级吸收二室开放模型,模型和参数可以为氯氮平的法医学鉴定提供实验依据。     

生物检材中芬太尼和舒芬太尼的HPLC-MS/MS分析

目的建立血、肝组织中芬太尼和舒芬太尼的HPLC-MS/MS分析方法。方法采用Oasis（MCX固相萃取柱进行提取,以XTerraTMRP18柱（2.1mm×100mm,3.5μm）色谱柱分离,以乙腈∶5mmol/L醋酸铵水溶液（氨水调pH=9.5）（65∶35）为流动相,流速为0.2mL/min。结果血及肝组织添加样品的线性范围为10ng/mL～500ng/mL,最小检出限为0.1ng/mL。结论本方法准确、快速,可用于生物检材血、肝组织中芬太尼和舒芬太尼的定性定量分析。     

气相色谱法快速分析人血、尿中地芬尼多

目的建立人血、尿中地芬尼多的气相色谱快速分析方法。方法用氯仿提取血、尿中的地芬尼多,采用气相色谱法进行定性、定量分析。以正常人血浆、尿液为空白样本,分别添加标准地芬尼多及SKF525（内标物）对方法进行考察和优化,并对1例大剂量误服地芬尼多中毒者体液浓度进行快速测定和检测。结果所建方法分析血、尿中地芬尼多的线性范围均为5.0～200.0μg/mL;最低检测限均为1.0μg/mL（S/N≥3）;日内、日间精密度RSD≤5.6%（n=5）;回收率：血≤（106.23±2.05）%;尿≤（104.19±5.51）%。结论该分析方法操作便捷、实用,适用于地芬尼多的临床血药浓度快速监测和法医毒物鉴定。     

The relationship between alcohol elimination rate and increasing blood alcohol concentration--calculated from two consecutive blood specimens

In the period 1991-2005, a blood-alcohol concentration (BAC) analysis was carried out at the Institute of forensic medicine in Novi Sad including 2023 two consecutive blood specimens using the Headspace Gas Chromatography method. Cases with no alcohol concentration values, as well as cases where blood samples were taken within 1 h after the criminal act, were not taken into consideration. Following this rule, 1198 cases were considered in this study and all samples were grouped in 29 ranges of BAC1 of delta(BAC) = 0.1 g/kg, starting from 0.1-0.19 g/kg to 2.9-2.99 g/kg of absolute alcohol. Gathered results and elimination curve differ from the zero-order model of elimination proposed by Widmark and point to an elimination process similar to a well-known Michaelis-Menten elimination kinetics model and its variants. Results reported in this study show dependence of alcohol elimination rate (beta-slope) and BAC value. The analysis of beta60-slope versus BAC shows that a correlation between beta60 (y) and BAC (x) has a logarithmic trend line. The value of alcohol elimination rate shows a slight increment with increase of BAC alcohol, with the mean value of beta60 = 0.221 +/- 0.075 g/kg. Differences in values of beta60 among consecutive intervals of delta(BAC) = 0.1 g/kg are not significant (p>0.05). When obtained samples were grouped into ranges of 0.5 g/kg each in these intervals beta60 had the following values by range: 0.1-0.49 g/kg = 0.139 g/kg +/- 0.035; 0.5-0.99 g/kg = 0.184 g/kg +/- 0.043; 1-1.49 g/kg = 0.213 g/kg +/- 0.052; 1.5-1.99 g/kg = 0.239 g/kg +/- 0.058; 2-2.49 g/kg = 0.265 g/kg +/- 0.073; 2.5-2.99 g/kg = 0.306 g/kg +/- 0.096. Differences in values of beta slope among consecutive intervals of delta(BAC) = 0.5 g/kg are significant (p<0.01). The elimination curve in the BAC interval 0.5-2.5 g/kg has a linear trend, while beta-slope (y)/BAC (x) correlation is given as beta60 = 0.15 g/kg + (0.05 g/kg x BAC). Retrograde calculation of the blood alcohol concentration in tempore criminis (BAC(tc)) based on the determined alcohol concentration in the blood specimen (BAC(t)) shows a statistically significant difference between BAC(tc) calculated using a standard zero-order model versus corrected methodology. The higher the BAC(t) and the longer the calculation time, the greater and statistically more significant (p<0.01) is the difference between the calculated values of BAC(tc).     

Elimination rates of breath alcohol

Legal driving limits are set coequally with 0.5 g/L blood alcohol concentration (BAC) or 0.25 mg/L breath alcohol concentration (BrAC) in Austria as well as in other European countries. As mostly some time elapses between BrAC measurement and driving offence, a back calculation of alcohol concentrations is often required. The calculation of hourly BrAC elimination rates can thereby help to avoid unnecessary variances. A study with 59 participants was performed under social conditions. BrAC was determined with the legally accredited Alcotest 7110 MK III A every 30 min, and concomitantly venous blood samples were drawn. Five hundred and four BrAC/BAC value pairs were evaluated. The overall mean peak BrAC was calculated with 0.456 mg/L (±0.119 mg/L standard deviation). The mean hourly BrAC elimination rate was overall determined with 0.082 mg/L per h (0.050–0.114, 95% range). Mean rate of females (0.087 mg/L h⁻¹) and the according 95% limits were statistically significantly higher than of males (mean rate 0.078 mg/L h⁻¹, p < 0.04). Our results confirm the possibility to implement hourly BrAC elimination rates, provided that adequate statistical ranges and basic forensic scientific rules that have been set up for alcohol back calculations are observed.     

Ethanol distribution ratios between urine and capillary blood in controlled experiments and in apprehended drinking drivers.

Healthy men drank 0.51, 0.68, and 0.85 g of ethanol per kilogram of body weight as neat whisky in the morning after an overnight fast. During 6 to 8 h after the whisky was consumed, nearly simultaneous specimens of fingertip blood and pooled bladder urine were obtained for analysis of ethanol using an enzymatic method. The mean ratios of ethanol concentration [urine alcohol concentration (UAC)/blood alcohol concentration (BAC)] were mostly less than unity during the absorption phase. The UAC exceeded the BAC in the postpeak phase. The mean UAC/BAC ratios varied between 1.4 and 1.7 when the BAC exceeded 0.50 mg/mL. When the BAC decreased below 0.40 mg/mL, the UAC/BAC ratios increased appreciably. The mean UAC/BAC ratios of ethanol were not dependent on the person's age between the ages of 20 and 60 years old, but there were large variations within the age groups. In apprehended drinking drivers (N = 654) with a mean BAC of 1.55 mg/mL, the UAC/BAC ratio of ethanol varied widely, with a mean value of 1.49. In 12 subjects (3.2%), the ratio was less than or equal to unity. In a second specimen of urine obtained approximately 60 min after an initial void (N = 135), the mean UAC/BAC ratio was 1.35 (standard deviation = 0.17). The magnitude of the UAC/BAC ratio of ethanol can help to establish whether the BAC curve was rising or falling at or near the time of voiding. The status of alcohol absorption needs to be documented if drinking drivers claim ingestion of alcohol after the offence or when back-estimation of the BAC from the time of sampling to the time of driving is required by statute.     

Disappearance rate of alcohol from the blood of drunk drivers calculated from two consecutive samples; what do the results really mean?

Based on a large material (N = 2354) of double blood specimens from drunk drivers apprehended in The Netherlands, we selected 1314 cases for further evaluation. The difference BAC2-BAC1 was used as index of alcohol elimination rate from the blood. The results ranged from below 0.10 to 0.64 mg/ml/h, with a mean of 0.22 mg/ml/h. At least about 2% of drivers were still absorbing alcohol as indicated by a rising BAC. Some likely mechanisms are discussed that might account for the wide range of alcohol elimination rates observed.     

Alcohol metabolism of local Chinese in Hong Kong: a statistical determination on the effects of various physiological factors

A study was designed to examine the elimination rate of alcohol from the body of the local Chinese after consumption of different types of alcoholic drinks. The breath alcohol of 184 healthy volunteers was determined and converted into blood alcohol levels after they finished drinking. Information on the type and volume of alcoholic drinks consumed, age group, sex, drinking habit, and drinking on empty stomach or with/after meal was recorded for each participant. The results show that the elimination rate of an individual can be explained in terms of physiological variables including sex and drinking habit. The determined elimination rates allow forensic toxicologists to back calculate the blood alcohol concentration (BAC) of the drivers at the time of accident in drunk driving cases. The elimination rates of blood alcohol at 95% prediction intervals for male and female are in the range of 9.5-23.8 mg/100 ml/h and 11.1-37.1 mg/100 ml/h, respectively.     

Evaluation of breath alcohol instruments II. In vivo experiments with Alcolmeter Pocket Model

The precision and accuracy of an Alcolmeter Pocket Model breath alcohol instrument have been investigated in experiments with human subjects under controlled conditions. The instrument response was zero in all tests with breath samples from alcohol-free subjects. The standard deviations of ethanol determinations in breath were ±0.0722 mg/ml during ethanol absorption and ±0.0416 mg/ml during ethanol elimination. The standard deviation during the elimination phase increased with ethanol concentration in the sample, being ±0.0416 mg/ml on average at a mean concentration of 0.420 mg/ml, corresponding to a coefficient of variation of 9.9%.The blood alcohol estimates using the Alcolmeter were somewhat too high during active absorption of ethanol, and too low during elimination, when a constant blood-breath alcohol ratio of 2100:1 was used to calibrate the instrument. During the elimination phase of ethanol kinetics and at a mean blood alcohol concentration of 0.50 mg/ml, the mean Alcolmeter result was 0.456 ± 0.169 mg/ml with 95% confidence, i.e. varying between 0.287 and 0.625 mg/ml 95 times out of 100 tests at this critical blood alcohol level.     

The rate and kinetic order of ethanol elimination

The rate and kinetic order of ethanol elimination was evaluated in human volunteers. Part I of the study involved dosing individuals with alcoholic beverages on two separate occasions. Breathalyzer tests were performed at 15-min intervals for a period of 5 h. Attention was focused on values obtained after peak blood ethanol levels had been reached. The second part of the study included having samples drawn from alcoholics at predetermined intervals during recovery from alcoholic intoxication. Blood ethanol concentration data was analyzed for kinetic order and a comparison of ethanol elimination rates of alcoholics and non-alcoholics was made. The predicative capability of estimating a BAC from both the zero and first order theories was also investigated.It was concluded that ethanol elimination is a zero order process. For subjects classified as non-drinkers (consume less than 6 ounces of ethanol/month), the mean ethanol elimination rate as determined in the study was 12 ± 4 mg/h. For subjects classified as social drinkers (consume more than 6 ounces but less than 30 ounces of ethanol/month), the mean ethanol elimination rate was 15 ± 4 mg%/h, and for alcoholics, the mean ethanol elimination rate was 30 ± 9 mg%/h. These results indicate that the rate of ethanol elimination increases with drinking experience.     

Comparison of ethanol concentrations in venous blood and end-expired breath during a controlled drinking study

Concentration-time profiles of ethanol were determined for venous whole blood and end-expired breath during a controlled drinking experiment in which healthy men (n=9) and women (n=9) drank 0.40-0.65 g ethanol per kg body weight in 20-30 min. Specimens of blood and breath were obtained for analysis of ethanol starting at 50-60 min post-dosing and then every 30-60 min for 3-6 h. This protocol furnished 130 blood-breath pairs for statistical evaluation. Blood-ethanol concentration (BAC, mg/g) was determined by headspace gas chromatography and breath-ethanol concentration (BrAC, mg/2l) was determined with a quantitative infrared analyzer (Intoxilyzer 5000S), which is the instrument currently used in Sweden for legal purposes. In 18 instances the Intoxilyzer 5000S gave readings of 0.00 mg/2l whereas the actual BAC was 0.08 mg/g on average (range 0.04-0.15 mg/g). The remaining 112 blood- and breath-alcohol measurements were highly correlated (r=0.97) and the regression relationship was BAC=0.10+0.91BrAC and the residual standard deviation (S.D.) was 0.042 mg/g (8.4%). The slope (0.91+/-0.0217) differed significantly from unity being 9% low and the intercept (0.10+/-0.0101) deviated from zero (t=10.2, P<0.001), indicating the presence of both proportional and constant bias, respectively. The mean bias (BAC - BrAC) was 0.068 mg/g and the 95% limits of agreement were -0.021 and 0.156 mg/g. The average BAC/BrAC ratio was 2448+/-540 (+/-S.D.) with a median of 2351 and 2.5th and 97.5th percentiles of 1836 and 4082. We found no significant gender-related differences in BAC/BrAC ratios, being 2553+/-576 for men and 2417+/-494 for women (t=1.34, P>0.05). The mean rate of ethanol disappearance from blood was 0.157+/-0.021 mg/(g per hour), which was very close to the elimination rate from breath of 0.161+/-0.021 mg/(2l per hour) (P>0.05). Breath-test results obtained with Intoxilyzer 5000S (mg/2l) were generally less than the coexisting concentrations of ethanol in venous blood (mg/g), which gives an advantage to the suspect who provides breath compared with blood in cases close to a threshold alcohol limit.