Wilke N, Janssen H, Fahrenhorst C, Hecker H, Manns M P, Brabant E-G, Tröger H D, Breitmeier D
Institute of Legal Medicine, Medical School Hannover, Hanover, Germany.
Int J Legal Med. 2007 Sep;121(5):385-94. doi: 10.1007/s00414-006-0132-8. Epub 2007 Jan 6.
To find out whether a certain cause of death or a certain length of an agonal period shows specific adrenaline or noradrenaline profiles, heart blood, femoral vein blood, liquor, urine and vitreous humour were taken from corpses (n = 98) at the Medical School Hannover, and noradrenaline and adrenaline were determined using high-performance liquid chromatography (HPLC). Corpses were classified according to the following five categories: short agony, long agony, state after hanging, state after asphyxiation and state after CPR with documented administration of epinephrine. Once results were collected the adrenaline/noradrenaline quotient was determined. It became clear that there were no significant differences regarding the concentration of adrenaline and noradrenaline in the various body fluids in relation to the above-mentioned categories. The means adrenaline/noradrenaline quotients in femoral vein blood were 0.21 +/- 0.29 for hanged persons, 0.38 +/- 0.47 for asphyxiated persons, 0.17 +/- 0.19 for those with short agony and 0.42 +/- 0.43 for those with long agony, significantly below 1 (p < 0.001; p = 0.001; p = 0.003). For condition after CPR we found an adrenaline/noradrenaline quotient of 2.81 +/- 5.8. In liquor the adrenaline/noradrenaline quotients for short agony was 0.17 +/- 0.17, for hanged persons 0.18 +/- 0.19 and for asphyxiated ones 0.30 +/- 0.38, significantly lower than 1 (p < 0.001). In urine the adrenaline/noradrenaline quotients for all categories are lower than 1 (p < 0.001); short agony (0.13 +/- 0.09), long agony (0.21 +/- 0.16), hanged (0.15 +/- 0.16), asphyxiated (0.14 +/- 0.08) and CPR (0.14 +/- 0.06). In vitreous humour the quotients for short agony (0.14 +/- 0.28), long agony (0.13 +/- 0.12), hanged (0.07 +/- 0.09) and asphyxiated (0.09 +/- 0.11) are lower than 1 (p < 0.001). The spread of data for the adrenaline/noradrenaline quotient did not allow for any conclusions about cause of death and length of agony in individual cases.
为了确定某一死因或某一濒死期时长是否呈现特定的肾上腺素或去甲肾上腺素特征,我们从汉诺威医学院的98具尸体上采集了心脏血液、股静脉血、脑脊液、尿液和玻璃体液,并使用高效液相色谱法(HPLC)测定去甲肾上腺素和肾上腺素。尸体根据以下五类进行分类:短濒死期、长濒死期、缢死状态、窒息状态和有记录使用肾上腺素的心肺复苏术后状态。一旦收集到结果,便测定肾上腺素/去甲肾上腺素比值。结果表明,上述各类别相关的不同体液中肾上腺素和去甲肾上腺素的浓度并无显著差异。股静脉血中,缢死者的肾上腺素/去甲肾上腺素平均比值为0.21±0.29,窒息者为0.38±0.47,短濒死期者为0.17±0.19,长濒死期者为0.42±0.43,均显著低于1(p<0.001;p = 0.001;p = 0.003)。对于心肺复苏术后状态,我们发现肾上腺素/去甲肾上腺素比值为2.81±5.8。脑脊液中,短濒死期者的肾上腺素/去甲肾上腺素比值为0.17±0.17,缢死者为0.18±0.19,窒息者为0.30±0.38,均显著低于1(p<0.001)。尿液中,所有类别的肾上腺素/去甲肾上腺素比值均低于1(p<0.001);短濒死期(0.13±0.09)、长濒死期(0.21±0.16)、缢死(0.15±0.16)、窒息(0.14±0.08)和心肺复苏术后(0.14±0.06)。玻璃体液中,短濒死期(0.14±0.28)、长濒死期(0.13±0.12)、缢死(0.07±0.09)和窒息(0.09±0.11)的比值均低于1(p<0.001)。肾上腺素/去甲肾上腺素比值的数据离散度不允许就个别案例的死因和濒死期时长得出任何结论。