De Letter Els A, Lambert Willy E, Bouche Marie-Paule L A, Cordonnier Jan A C M, Van Bocxlaer Jan F, Piette Michel H A
Department of Forensic Medicine, Ghent University, Jozef Kluyskensstraat 29, 9000 Gent, Belgium.
Int J Legal Med. 2007 Jul;121(4):303-7. doi: 10.1007/s00414-006-0094-x. Epub 2006 Apr 25.
In this manuscript, a newly identified compound, 3,4-methylenedioxy-N,N-dimethylamphetamine (MDDM or also called MDDA), was quantified. The substance was identified in the biological specimens of a 31-year-old man who died following a massive 3,4-methylenedioxymethamphetamine (MDMA) overdose. In addition, the postmortem distribution of the identified substance in various body fluids and tissues was evaluated. For MDDM quantitation, a formerly reported and validated liquid chromatography tandem mass spectrometry (LC-MS/MS) method was adapted. The following quantitative results of the MDDM quantitation were obtained: Femoral blood, aorta ascendens, and right atrial blood contained 2.5, 21.7, and 11.6 ng MDDM/ml, respectively. In left and right pleural fluid and pericardial fluid, concentrations of 47.0, 21.7, and 31.9 ng/ml, respectively, were found. MDDM levels in urine, bile, and stomach contents were 42.4, 1,101, and 1,113 ng/ml, respectively. MDDM concentrations in lungs, liver, kidney, and left cardiac muscle ranged from 12.8 to 39.8 ng/g, whereas these levels were below the limit of quantitation (< LOQ) in right cardiac and iliopsoas muscle. In conclusion, for the first time, MDDM was unambiguously identified in a fatal MDMA overdose. MDDM was probably present as a synthesis by-product or impurity in the MDMA tablets, which were taken in a huge amount by the victim, or MDDM was ingested separately and prior to the MDMA overdose. A third option, i.e., the eventual formation of MDDM as a result of postmortem methylation of MDMA by formaldehyde, produced by putrefaction processes or during storage under frozen conditions, is also discussed. The MDDM levels, substantiated in various body fluids and tissues, are in line with the distribution established for other amphetamine derivatives and confirm that peripheral blood sampling, such as that of femoral blood, remains the "golden standard".
在本手稿中，对一种新鉴定出的化合物3,4-亚甲基二氧基-N,N-二甲基苯丙胺（MDDM，也称为MDDA）进行了定量分析。该物质是在一名31岁男子的生物样本中鉴定出来的，该男子因大量服用3,4-亚甲基二氧基甲基苯丙胺（摇头丸）过量死亡。此外，还评估了该鉴定物质在各种体液和组织中的死后分布情况。对于MDDM定量分析，采用了先前报道并经过验证的液相色谱串联质谱（LC-MS/MS）方法。获得了以下MDDM定量分析的结果：股静脉血、升主动脉血和右心房血中MDDM的含量分别为2.5、21.7和11.6 ng/ml。在左、右胸腔积液和心包积液中，浓度分别为47.0、21.7和31.9 ng/ml。尿液、胆汁和胃内容物中的MDDM水平分别为42.4、1101和1113 ng/ml。肺、肝、肾和左心肌中的MDDM浓度范围为12.8至39.8 ng/g，而右心肌和髂腰肌中的这些水平低于定量限（<LOQ）。总之，首次在致命的摇头丸过量案例中明确鉴定出MDDM。MDDM可能是作为合成副产物或杂质存在于受害者大量服用的摇头丸片剂中，或者是在摇头丸过量服用之前单独摄入的。还讨论了第三种可能性，即由于尸体腐烂过程或冷冻保存期间甲醛对摇头丸进行死后甲基化最终形成MDDM。在各种体液和组织中证实的MDDM水平与其他苯丙胺衍生物的分布情况一致，并证实外周血采样，如股静脉血采样，仍然是“金标准”。
