Skopp Gisela
Institute of Legal Medicine, University Hospital, Voss-Str. 2, 69115 Heidelberg, Germany.
Forensic Sci Med Pathol. 2010 Dec;6(4):314-25. doi: 10.1007/s12024-010-9150-4. Epub 2010 Mar 4.
Results from toxicological analyses in death investigations are used to determine whether foreign substances were a cause of death, whether they contributed to death, or whether they caused impairment. Drug concentrations are likely to change during pre-terminal stages due to altered pharmacokinetics, to treatment during resuscitation or in the intensive care unit, to concomitant illness or to the presence of drug tolerance. The potential for postmortem changes must be considered in all but a few drugs. Formation of new entities as well as degradation of drugs may occur, especially in putrefied corpses; in addition, body fluids and tissues may be severely affected by autolysis and putrefaction. Specimens should be selected based on individual case history and on their availability. Analytical procedures should be performed in accordance with a proper quality assurance program for toxicological investigations. Problems are most likely to occur during the isolation and identification of a drug. Interpretation of analytical results is often limited by the inadequate information provided in a particular case.
死亡调查中的毒理学分析结果用于确定外来物质是否为死因、是否促成死亡或是否造成损害。由于药代动力学改变、复苏期间或重症监护病房的治疗、伴发疾病或药物耐受性的存在，药物浓度在濒死期可能会发生变化。除少数药物外，必须考虑死后变化的可能性。新物质的形成以及药物的降解都可能发生，尤其是在腐败尸体中；此外，体液和组织可能会受到自溶和腐败的严重影响。应根据个案病史及其可获得性选择标本。分析程序应按照适当的毒理学调查质量保证计划进行。问题最有可能出现在药物的分离和鉴定过程中。分析结果的解释往往受到特定案例中所提供信息不足的限制。
