Division of Forensic Toxicology and Drug Abuse, Norwegian Institute of Public Health, PB. 4404 Nydalen, 0403 Oslo, Norway.
Eur J Clin Pharmacol. 2010 Oct;66(10):987-98. doi: 10.1007/s00228-010-0870-x. Epub 2010 Aug 18.
information on the clinical effects associated with whole blood gamma-hydroxybutyrate (GHB) concentrations is sparse. We have investigated possible relationships between GHB blood concentrations and clinical effects in car drivers.
in Norway, the police stop car drivers suspected of drug-driving. Medical doctors perform a clinical test of impairment (CTI) and blood samples are screened for drugs/medicines by immunological, enzymatic and chromatographic methods at the Division of Forensic Toxicology and Drug Abuse. GHB is a part of our extended drug-testing programme. GHB is standardly measured as GBL by gas chromatographic method. All the results were stored in a database. This database was searched between 2000 and 2007 for car drivers positive only for GHB, called GHB-drivers. A control group with a completely negative blood analysis, including GHB, called control-drivers, was included in the study.
twenty-five car drivers had only GHB in their blood. The police reported that 78% showed unsafe driving behaviour and seven were involved in car accidents, without serious injury. A total of 61% of the drivers were found to be sleepy or in an even more reduced state of consciousness. The median GHB blood concentration was 1,262 (range 592-2,191) μmol/L, measured a median of 69 min after the police had stopped the driver from driving. The GHB blood concentration tended to increase with increasing impairment and reduced consciousness. Clinical findings were normal- to large-sized pupils (86%), impairment as the final conclusion (84%), impaired balance/nystagmus (62 and 54%, respectively), congested/shiny conjunctiva (67%), apathetic, aggressive or abnormal behaviour (65%), reduced short-term memory (67%), reduced/absent pupillar reaction to light (65%), heart rate ≤ 70 beats/min (56%), and some level of reduced consciousness (56%). In the control-drivers, 15.6% were found by the medical doctors to have reduced consciousness or impaired.
the median GHB blood concentration of the 25 car drivers was high. Most drivers had clinical impairment that was not explainable by injuries, with depressive effects on the central nervous system and sympathomimetic effects on eyes. Effects on impairment and consciousness tended to be concentration-dependent. The number of drivers who were impaired or had reduced consciousness was highly increased in GHB-drivers compared to controls. Based on these results, we conclude that the GHB-drivers most probably drove in an unsafe manner due to impairment by GHB.
关于全血 γ-羟基丁酸（GHB）浓度相关的临床效果的信息很少。我们研究了驾驶员血液中 GHB 浓度与临床效果之间的可能关系。
在挪威，警察会拦下涉嫌毒驾的汽车司机。医生会进行临床损伤测试（CTI），并通过免疫、酶和色谱方法对 Division of Forensic Toxicology and Drug Abuse 处的血液样本进行药物/药物筛查。GHB 是我们扩展药物检测计划的一部分。GHB 通常通过气相色谱法测量为 GBL。所有结果均存储在数据库中。该数据库从 2000 年到 2007 年搜索了仅对 GHB 呈阳性的汽车驾驶员，称为 GHB 驾驶员。研究还包括一组完全无血液分析（包括 GHB）的对照组，称为对照驾驶员。
25 名汽车驾驶员的血液中只有 GHB。警方报告称，78%的驾驶员表现出不安全的驾驶行为，7 人发生车祸，但没有严重受伤。共有 61%的驾驶员表现出困倦或更严重的意识降低。GHB 血液浓度的中位数为 1,262（范围 592-2,191）μmol/L，在警察阻止驾驶员驾驶后中位数 69 分钟测量。GHB 血液浓度随着损伤和意识降低而增加。临床发现为正常至大瞳孔（86%）、最终结论为损伤（84%）、平衡/眼球震颤受损（分别为 62%和 54%）、结膜充血/发亮（67%）、冷漠、攻击性或异常行为（65%）、短期记忆减少（67%）、瞳孔对光反应减少/消失（65%）、心率≤70 次/分钟（56%）和一定程度的意识降低（56%）。在对照驾驶员中，有 15.6%的驾驶员被医生发现存在意识降低或损伤。
25 名汽车驾驶员的 GHB 血液浓度中位数较高。大多数驾驶员存在无法用损伤解释的临床损伤，对中枢神经系统产生抑郁作用，对眼睛产生拟交感作用。损伤和意识的影响似乎与浓度有关。与对照组相比，GHB 驾驶员中损伤或意识降低的驾驶员数量明显增加。基于这些结果，我们得出结论，由于 GHB 损伤，GHB 驾驶员很可能以不安全的方式驾驶。
