Stimpfl T, Reichel S
Department of Forensic Medicine, Medical University of Vienna, Vienna, Austria.
Forensic Sci Int. 2007 Aug 6;170(2-3):179-82. doi: 10.1016/j.forsciint.2007.03.032. Epub 2007 Jul 16.
Since concentration of drugs of abuse found in the brain better reflect drug concentration at their site of action, brain specimens are useful in the determination of the role of drugs of abuse in the cause of death. In order to allow for the routine use of brain specimens in this field, a comprehensive database with reliable reference values is needed and should include both post-mortem data for cases where drugs have been taken in therapeutic doses as well as for cases of overdose. In this study, a semi-automated extraction procedure, in combination with gas chromatography/mass spectrometry (GC-MS) using stable isotope internal standards was applied to yield reproducible, quantitative results which could be used to investigate the distribution patterns of drugs of abuse within specific regions of the brain, by analyzing several segments of both medulla oblongata and cerebellum. A homogenous distribution of unconjugated morphine, dihydrocodeine, and benzoylecgonine within the investigated segments of medulla oblongata or cerebellum could be found. However, when these two brain regions from the same case were compared to each other, significantly higher concentrations of unconjugated morphine, dihydrocodeine, and benzoylecgonine were found in the cerebellum than in the medulla oblongata.
由于在大脑中发现的滥用药物浓度能更好地反映药物在其作用部位的浓度，因此脑标本对于确定滥用药物在死因中的作用很有用。为了在该领域常规使用脑标本，需要一个具有可靠参考值的综合数据库，该数据库应包括药物以治疗剂量服用的病例以及过量用药病例的尸检数据。在本研究中，采用了一种半自动提取程序，并结合使用稳定同位素内标物的气相色谱/质谱联用（GC-MS）技术，以产生可重复的定量结果，通过分析延髓和小脑的几个节段，可用于研究滥用药物在大脑特定区域内的分布模式。在延髓或小脑的研究节段内可发现未结合的吗啡、二氢可待因和苯甲酰爱康宁分布均匀。然而，当将同一病例的这两个脑区相互比较时，发现小脑中未结合的吗啡、二氢可待因和苯甲酰爱康宁的浓度明显高于延髓。
