全血一氧化碳 (TBCO) 的死后度作为一氧化碳 (CO) 中毒的新生物标志物
Stefania Oliverio1,2, Marie-Caroline Ferger1, Michel Yegles1
1Department of Forensic Medicine, Laboratoire National de Santé, 1 Rue Louis Rech, Dudelange 3555, Luxemburg.
Journal of analytical toxicology
|April 25, 2024
概括
全血一氧化碳 (TBCO) 为诊断一氧化碳 (CO) 中毒提供了比碳氧血球蛋白 (COHb) 更稳定和准确的测量方法. 这项研究确定了死后病例中TBCO的参考值,有助于其常规临床使用.
科学领域:
- 法医毒理学 法医毒理学
- 分析化学 分析化学
背景情况:
- 碳氧血球蛋白 (COHb) 是一氧化碳 (CO) 中毒的标准生物标志物,但缺乏总体血液一氧化碳 (TBCO) 的确定的参考值.
- 在各种储存条件下,TBCO具有更高的准确性和稳定性,使其成为潜在的替代生物标志物.
研究的目的:
- 在死后CO中毒病例中确定TBCO的参考值.
- 评估TBCO作为可靠的生物标志物,用于在法医环境中诊断CO中毒.
主要方法:
- 气色谱质谱法 (GC-MS) 用于分析92次尸体解剖的血液样本中的TBCO.
- 样本包括来自CO相关和非CO相关病例的心脏,外周,头骨和脏血液,以及各种各样的死后间隔 (PMI).
主要成果:
- 在非CO相关的病例中,在低PMI下没有观察到显著的CO形成/降解.
- 在CO相关病例的心脏血液中发现了COHb和TBCO之间的正相关性 (R=0.78),尽管TBCO可能会提供更全面的评估.
- 建议的TBCO度组用于CO暴露:<6μmol/mL (没有),6-20μmol/mL (中等) 和>20μmol/mL (高).
结论:
- 测量TBCO对于准确的CO中毒诊断至关重要,可能检测出比单独的COHb更高的CO暴露.
- 已确立的TBCO参考值有助于在例行尸体分析中实现该标准.
- 脏血液显示出作为CO确定替代矩阵的希望.
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