Moriya Fumio, Hashimoto Yoshiaki
Department of Legal Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
Leg Med (Tokyo). 2003 Mar;5 Suppl 1:S91-5. doi: 10.1016/s1344-6223(02)00074-3.
A 57-year-old man was found dead lying down in a bamboo thicket. Moderate to severe petechiae were present on his conjunctivae, buccal mucosa, and laryngeal mucosa at autopsy. Cardiac chambers contained a normal volume of fluid blood. Moderate atherosclerosis and fatty liver were observed. No remarkable changes, other than congestion in other organs, were observed. Gas chromatographic screening of the stomach contents, blood and urine was positive for triazolam and alpha-hydroxytriazolam that were confirmed by gas chromatography-mass spectrometry. Blood concentrations of triazolam and free alpha-hydroxytriazolam were 62-251 and 10-66 ng/ml, respectively. A substantial amount of triazolam was detected in bile (1130 ng/ml), but not in urine. Free and total alpha-hydroxytriazolam concentrations were 3920 and 7050 ng/ml, respectively, in the bile and 3710 and 9670 ng/ml, respectively, in urine. Organs contained 216-583 ng/g triazolam. The concentration of free alpha-hydroxytriazolam in the kidney (246 ng/g) was higher than in any other organ. Free alpha-hydroxytriazolam was not detected in the liver. The concentrations of total alpha-hydroxytriazolam in the liver and kidney were 784 and 381 ng/g, respectively. Free to total ratios of alpha-hydroxytriazolam were 0.14-0.56 in fluid samples and 0.56-0.92 in tissue samples, except for the liver. A large quantity of triazolam (8.4 mg) remained in the stomach. The victim probably died of postural asphyxia caused by triazolam poisoning.
一名57岁男子被发现死在一片竹林中。尸检时，其结膜、颊黏膜和喉黏膜出现中度至重度瘀点。心腔内有正常量的血液。观察到中度动脉粥样硬化和脂肪肝。除其他器官充血外，未观察到明显变化。对胃内容物、血液和尿液进行气相色谱筛查，结果显示三唑仑和α-羟基三唑仑呈阳性，经气相色谱-质谱联用仪确认。三唑仑和游离α-羟基三唑仑的血药浓度分别为62-251 ng/ml和10-66 ng/ml。胆汁中检测到大量三唑仑（1130 ng/ml），但尿液中未检测到。胆汁中游离α-羟基三唑仑和总α-羟基三唑仑浓度分别为3920 ng/ml和7050 ng/ml，尿液中分别为3710 ng/ml和9670 ng/ml。各器官中三唑仑含量为216-583 ng/g。肾脏中游离α-羟基三唑仑浓度（246 ng/g）高于其他任何器官。肝脏中未检测到游离α-羟基三唑仑。肝脏和肾脏中总α-羟基三唑仑浓度分别为784 ng/g和381 ng/g。除肝脏外，液体样本中α-羟基三唑仑的游离与总比值为0.14-0.56，组织样本中为0.56-0.92。胃内残留大量三唑仑（8.毫克）。受害者可能死于三唑仑中毒导致的体位性窒息。
