Steentoft Anni, Linnet Kristian
The Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Frederik V vej 11, DK-2100 Copenhagen Ø, Denmark.
Forensic Sci Int. 2009 Jan 30;184(1-3):74-9. doi: 10.1016/j.forsciint.2008.12.004. Epub 2009 Jan 16.
The benzodiazepine clonazepam is a prescription drug used to treat epilepsy and anxiety. In addition, it is frequently used to treat drug addicts and is itself a popular drug of abuse. In this study, we report the incidence and blood concentrations of clonazepam and its metabolite 7-aminoclonazepam in cases referred to the Section of Forensic Chemistry at the University of Copenhagen in 2002-2007. Using LC-MS/MS, clonazepam was detected in 297 traffic cases, 92 criminal cases (perpetrators or victims of a crime) and in 140 postmortem cases. The concentration ranges of clonazepam+7-aminoclonazepam were 0.002-0.840 mg/kg (median 0.067) for traffic cases, 0.005-0.913 (median 0.071) for criminal cases (offenders), 0.002-0.720 (median 0.030) for criminal cases (victims) and 0.002-1.676 (median 0.115) for postmortem cases. The concentrations were thus similar among the groups, although the median value was highest in the postmortem group. In most cases, other drugs were also present. For the postmortem group, the cases (n=27) with relatively high (>0.2 mg/kg) clonazepam+7-aminoclonazepam values were examined in greater detail. Other drugs were present in all cases, with clonazepam judged to be the primary cause of death in five cases. The range of clonazepam+7-aminoclonazepam concentrations in these five cases ranged from 0.26 to 0.54 mg/kg (median 0.29 mg/kg).
苯二氮䓬类药物氯硝西泮是一种用于治疗癫痫和焦虑症的处方药。此外，它还经常用于治疗吸毒者，并且其本身也是一种常见的滥用药物。在本研究中，我们报告了2002年至2007年转至哥本哈根大学法医学系的案例中氯硝西泮及其代谢物7-氨基氯硝西泮的发生率和血药浓度。使用液相色谱-串联质谱法（LC-MS/MS），在297起交通案件、92起刑事案件（犯罪者或受害者）和140起尸检案件中检测到了氯硝西泮。交通案件中氯硝西泮+7-氨基氯硝西泮的浓度范围为0.002 - 0.840毫克/千克（中位数0.067），刑事案件（犯罪者）为0.005 - 0.913（中位数0.071），刑事案件（受害者）为0.002 - 0.720（中位数0.030），尸检案件为0.002 - 1.676（中位数0.115）。因此，尽管尸检组的中位数最高，但各组之间的浓度相似。在大多数情况下，还存在其他药物。对于尸检组，对氯硝西泮+7-氨基氯硝西泮值相对较高（>0.2毫克/千克）的病例（n = 27）进行了更详细的检查。所有病例中均存在其他药物，其中5例中氯硝西泮被判定为主要死因。这5例中氯硝西泮+7-氨基氯硝西泮的浓度范围为0.26至0.54毫克/千克（中位数0.29毫克/千克）。
