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:S113-7. doi: 10.1016/s1344-6223(02)00079-2.
The purpose of this study was to examine the effects of methemoglobinemia caused by fire gases on blood cyanide concentrations in fire victims. Twenty-two fire victims with postmortem intervals of 8-48 h were involved. Blood cyanide concentrations at the time of death (C(0)) were estimated using the formula: C(0)=Ce(0.046 t) (C=blood cyanide concentration detected at autopsy, 0.046=first-order rate constant of cyanide disappearing from blood in corpses, and t=postmortem interval). Total (free and combined with cyanide) methemoglobin (MetHb) content was used to estimate the maximum capacity of MetHb for combining cyanide. Blood cyanide concentrations at the time of death were very high (5.32-6.47 mg/l) in five victims. Three showed high saturation (54.7-63.0%) of carboxyhemoglobin (CO-Hb) and elevated total MetHb contents (2.6-5.0%). MetHb at these levels is capable of scavenging up to 8.6-11.4 mg/l of blood cyanide. Thus, blood cyanide might have been completely combined with MetHb at the time of their death. In the remaining two victims, CO-Hb saturation was not high (30.9 and 37.9%) and no free MetHb was detected. As a result they may have exhibited severe toxic effects of cyanide at the time of their death. Our results indicate that MetHb contents and CO-Hb saturation should be determined to evaluate the toxic effects of cyanide in fire victims.
本研究的目的是检测火灾产生的气体导致的高铁血红蛋白血症对火灾受害者血液中氰化物浓度的影响。研究涉及22名死后间隔时间为8 - 48小时的火灾受害者。使用公式C(0)=Ce(0.046 t)估算死亡时的血液氰化物浓度（C(0)）（C =尸检时检测到的血液氰化物浓度，0.046 =氰化物在尸体血液中消失的一级速率常数，t =死后间隔时间）。总高铁血红蛋白（MetHb）含量（游离的和与氰化物结合的）用于估算MetHb结合氰化物的最大能力。五名受害者死亡时的血液氰化物浓度非常高（5.32 - 6.47毫克/升）。三名受害者显示出高饱和度（54.7 - 63.0%）的碳氧血红蛋白（CO - Hb）以及升高的总MetHb含量（2.6 - 5.0%）。处于这些水平的MetHb能够清除高达8.6 - 11.4毫克/升的血液氰化物。因此，在他们死亡时血液中的氰化物可能已完全与MetHb结合。在其余两名受害者中，CO - Hb饱和度不高（分别为30.9%和37.9%），且未检测到游离的MetHb。结果，他们在死亡时可能表现出氰化物的严重毒性作用。我们的结果表明，应测定MetHb含量和CO - Hb饱和度以评估火灾受害者中氰化物的毒性作用。
