Bajanowski T, Brinkmann B, Mitchell E A, Vennemann M M, Leukel H W, Larsch K-P, Beike J
Institute of Legal Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.
Int J Legal Med. 2008 Jan;122(1):23-8. doi: 10.1007/s00414-007-0155-9. Epub 2007 Feb 7.
The aim of this component of the German Study on Sudden Infant Death was to determine (1) nicotine concentrations in hair (NCH), as a marker of long standing exposure to tobacco, (2) cotinine concentrations in pericardial fluid (CCP) and (3) cotinine concentrations in liquor cerebrospinalis (CCL), the latter measures being markers of recent exposure to tobacco in the last few hours of life. The results obtained were compared with data on parental smoking revealed from interviews. In 100 cases of sudden infant death syndrome, material was taken at autopsy to determine NCH. In 41 cases, NCH and CCP, and in 70 cases, NCH and CCL were determined. Infants of mothers who stated having smoked during pregnancy had higher NCH than infants of non-smoking mothers (p = 0.008). Furthermore, there was a weak but statistically significant relationship between NCH's and the daily cigarette consumption of the mother during pregnancy (n = 64, r = 0.24, p = 0.05). In 43% of infants, nicotine could be detected in their hair, although the mothers had said at the interview that they did not smoke during pregnancy. On the other hand, in 33% of infants whose mother stated they had smoked during pregnancy nicotine was not detectable in the infant's hair. CCP's were strongly correlated with CCL's (r = 0.62, p = 0.0027). For this reason, both parameters were treated as equivalent for the detection of tobacco smoke exposure in the last hours before death. The influence of breast-feeding was evaluated by comparison of the nicotine concentrations in breast fed and non-breast-fed infants from smokers and non-smokers. Fivefold higher nicotine concentrations were determined in non-breast-fed infants of parents who smoked as compared to all other groups. It can be concluded that nicotine intake by passive smoking is much more important than by breast-feeding. We conclude that both interview data and biochemical measures should be sought to understand the true exposure to tobacco smoke.
（1）头发中的尼古丁浓度（NCH），作为长期接触烟草的标志物；（2）心包液中的可替宁浓度（CCP）；（3）脑脊液中的可替宁浓度（CCL），后两项指标是婴儿生命最后几小时内近期接触烟草的标志物。将获得的结果与通过访谈揭示的父母吸烟数据进行比较。在100例婴儿猝死综合征病例中，尸检时采集样本以测定NCH。在41例病例中测定了NCH和CCP，在70例病例中测定了NCH和CCL。声称在孕期吸烟的母亲所生婴儿的NCH高于不吸烟母亲所生婴儿（p = 0.008）。此外，NCH与母亲孕期每日吸烟量之间存在微弱但具有统计学意义的关系（n = 64，r = 0.24，p = 0.05）。在43%的婴儿头发中可检测到尼古丁，尽管母亲在访谈中表示她们在孕期不吸烟。另一方面，在33%声称母亲在孕期吸烟的婴儿头发中未检测到尼古丁。CCP与CCL高度相关（r = 0.62，p = 0.0027）。因此，在检测死亡前最后几小时内的烟草烟雾暴露时，将这两个参数视为等效。通过比较吸烟和不吸烟的母乳喂养和非母乳喂养婴儿的尼古丁浓度来评估母乳喂养的影响。与所有其他组相比，父母吸烟的非母乳喂养婴儿的尼古丁浓度高出五倍。可以得出结论，被动吸烟摄入尼古丁比母乳喂养更为重要。我们得出结论，为了解真正的烟草烟雾暴露情况，应同时寻求访谈数据和生化检测手段。
