Vanbinst R, Koenig J, Di Fazio V, Hassoun A
Laboratory of Toxicology, St-Luc Hospital, Université catholique de Louvain, Hippocrate Avenue 10, 1200, Brussels, Belgium.
Forensic Sci Int. 2002 Aug 14;128(1-2):35-40. doi: 10.1016/s0379-0738(02)00161-5.
Bile is, in certain cases, collected together with blood from different sites (heart, brain, femoral), urine and other organs or matrices. This study reports comparative results obtained from the analysis of blood and bile for different drugs found: acetaminophen, amphetamine and related compounds, several antidepressants, several benzodiazepines, cocaine and its metabolites, dextropropoxyphene and its metabolite, hydroxyzine, methadone and metabolite, morphine and codeine, levomepromazine, thioridazine, propranolol, tramadol and its metabolite. Several findings are presented: (1) There were no significant differences in the levels of the compounds among the samples of blood obtained from different sites. (2) Levels in bile are generally several fold higher than those in blood. The mean bile to blood ratios vary from about 1 (for acetaminophen, amphetamine) to about 2000 (for desmethylclobazam). (3) In certain cases (16 over 44), although the drug or its metabolite was not detected in blood from different sites, it was detected in bile. As other authors had advocated, it is very useful to ask the pathologist to take the gall bladder with its contents together with the other samples, in order that the sample of bile can be used in the comprehensive toxicological analysis and therefore be complementary to the other fluids or matrices. An additional advantage for using bile is that the concentrations of drugs or their metabolites are generally several fold higher than their blood concentrations.
在某些情况下，胆汁与来自不同部位（心脏、大脑、股部）的血液、尿液及其他器官或基质一起采集。本研究报告了对血液和胆汁中不同药物（对乙酰氨基酚、苯丙胺及相关化合物、几种抗抑郁药、几种苯二氮䓬类药物、可卡因及其代谢物、右丙氧芬及其代谢物、羟嗪、美沙酮及其代谢物、吗啡和可待因、左美丙嗪、硫利达嗪、普萘洛尔、曲马多及其代谢物）分析所获得的比较结果。呈现了几个发现：（1）从不同部位采集的血液样本中这些化合物的水平没有显著差异。（2）胆汁中的水平通常比血液中的高几倍。胆汁与血液的平均比值从约1（对乙酰氨基酚、苯丙胺）到约2000（去甲基氯巴占）不等。（3）在某些情况下（44例中有16例），尽管在不同部位的血液中未检测到药物或其代谢物，但在胆汁中检测到了。正如其他作者所主张的，要求病理学家将胆囊及其内容物与其他样本一起采集非常有用，以便胆汁样本可用于全面的毒理学分析，从而补充其他体液或基质。使用胆汁的另一个优点是药物或其代谢物的浓度通常比其血液浓度高几倍。
