Høiseth Gudrun, Karinen Ritva, Christophersen Asbjørg S, Olsen Linda, Normann Per Trygve, Mørland Jørg
Norwegian Institute of Public Health, Division of Forensic Toxicology and Drug Abuse, Pb 4404 Nydalen, N-0403 Oslo, Norway.
Forensic Sci Int. 2007 Jan 5;165(1):41-5. doi: 10.1016/j.forsciint.2006.02.045. Epub 2006 Mar 27.
The possibility of post-mortem production of ethanol makes correct interpretation of ethanol detection in forensic autopsy samples difficult. Even though the levels of ethanol formed post-mortem are generally low, this may be highly relevant in cases where intake of alcohol was forbidden, for instance for pilots, professional drivers and countries with low legal alcohol limits for driving. Different criteria are used to determine whether a finding of ethanol is of exogenous origin, but there is no marker for alcohol ingestion that has been studied in detail. In this study, we wanted to evaluate the sensitivity and specificity of ethyl glucuronide (EtG), a direct minor metabolite of ethanol, measured in blood, as a marker of ante-mortem alcohol ingestion. Forensic autopsy cases were divided into groups with and without ante-mortem alcohol ingestion, according to strict inclusion criteria. In 93 cases with information on ante-mortem alcohol ingestion, EtG was detected in blood in all cases, even when levels of ethanol were low. In another 53 cases where there were no indications of ante-mortem alcohol intake, EtG could not be detected in blood in a single case, also in 11 cases in which ethanol was detected and considered to be most probably formed post-mortem. In conclusion, blood EtG determination seems to be a reliable marker of ante-mortem ingestion of alcohol, and it could be considered in forensic autopsy cases when post-mortem formation of ethanol is questioned.
死后产生乙醇的可能性使得对法医尸检样本中乙醇检测结果的正确解读变得困难。尽管死后形成的乙醇水平通常较低，但在禁止饮酒的情况下，比如对于飞行员、职业司机以及法定驾驶酒精限量较低的国家，这可能具有高度相关性。人们使用不同标准来确定乙醇检测结果是否源于外部摄入，但尚未对一种用于酒精摄入的标志物进行详细研究。在本研究中，我们想要评估血液中测量的乙醇直接微量代谢产物——乙基葡萄糖醛酸（EtG）作为生前酒精摄入标志物的敏感性和特异性。根据严格的纳入标准，法医尸检案例被分为生前有酒精摄入和无酒精摄入两组。在93例有生前酒精摄入信息的案例中，即便乙醇水平较低，所有案例的血液中均检测到了EtG。在另外53例无生前酒精摄入迹象的案例中，没有一个案例的血液中检测到EtG，在11例检测到乙醇且认为很可能是死后形成的案例中也未检测到EtG。总之，血液EtG测定似乎是生前酒精摄入的可靠标志物，在对死后乙醇形成存疑的法医尸检案例中可以考虑使用。
