Wasfi Ibrahim A, Zorob Omar, Al katheeri Nawal A, Al Awadhi Anwar M
Department of Forensic Evidence, Forensic Science Laboratory, Abu Dhabi, PO Box 253, United Arab Emirates.
Forensic Sci Int. 2008 Aug 6;179(2-3):e31-6. doi: 10.1016/j.forsciint.2008.05.002. Epub 2008 Jul 7.
The study presents a case of fatal poisoning with oleander leaves in an adult diabetic male. After repeated vomiting, and gastrointestinal distress the patient was admitted at the hospital with cardiac symptoms 1h after the ingestion. Urine samples were assayed immunochemically and by GC-MS for drugs of abuse and for general toxicological screen. Blood was analyzed for alcohol and volatiles by static head space GC-MS. Blood and oleander leaves were analyzed by LC-MS/MS for oleandrin and related compounds, the main cardiac glycosides of Nerium oleander. Oleandrin was detected by LC-MS/MS in the blood sample at a concentration of approximately 10 ng/ml. Another cardiac glycoside with pseudo-molecular ion of m/z 577, a likely structural isomer of oleandrin, was also detected in the blood and oleander leaves. However, by using the response as a function of concentration for oleandrin, this cardiac glycoside was roughly estimated at a concentration of approximately 10 ng/ml in the deceased blood. This would give a total fatal blood concentration of cardiac glycosides of about approximately 20 ng/ml in the deceased blood.
该研究报告了一例成年糖尿病男性因夹竹桃叶中毒致死的病例。在反复呕吐和出现胃肠道不适后，患者在摄入夹竹桃叶1小时后因心脏症状入院。对尿液样本进行免疫化学分析，并通过气相色谱 - 质谱联用（GC-MS）检测滥用药物和进行一般毒理学筛查。通过静态顶空气相色谱 - 质谱联用分析血液中的酒精和挥发性物质。采用液相色谱 - 串联质谱（LC-MS/MS）分析血液和夹竹桃叶中的夹竹桃苷及相关化合物，夹竹桃苷是夹竹桃的主要强心苷。通过LC-MS/MS在血液样本中检测到夹竹桃苷，浓度约为10 ng/ml。在血液和夹竹桃叶中还检测到另一种强心苷，其准分子离子峰为m/z 577，可能是夹竹桃苷的结构异构体。然而，利用夹竹桃苷的响应与浓度的函数关系，估计死者血液中该强心苷的浓度约为10 ng/ml。这将使死者血液中强心苷的总致死浓度约为20 ng/ml。
